Download PDF
Pneumologie 2016; 70(01): 23-27
DOI: 10.1055/s-0041-109383
Original Paper
© Georg Thieme Verlag KG Stuttgart · New York

Severe Complications of Ultrasound Guided Transbronchial Needle Aspiration – A Case Series and Review of the Literature

Schwergradige Komplikationen nach EBUS-TBNA – Fallserie und Literaturübersicht
C. Giesa
1   Klinik für Pneumologie und Infektiologie, Thoraxzentrum Ruhrgebiet
,
L. Heining
1   Klinik für Pneumologie und Infektiologie, Thoraxzentrum Ruhrgebiet
,
E. Hecker
2   Klinik für Thoraxchirurgie, Evangelisches Krankenhaus Herne, Germany
,
S. Ewig
1   Klinik für Pneumologie und Infektiologie, Thoraxzentrum Ruhrgebiet
› Author Affiliations
Further Information

Publication History

received 29 September 2015

accepted 10 November 2015

Publication Date:
20 January 2016 (online)

Also available at
   Permissions and Reprints

Abstract

Endobronchial ultrasound guided transbronchial needle aspiration (EBUS-TBNA) has become essential for the workup of patients with lung cancer and other pulmonary diseases. The emphasis of currently available literature is related to the diagnostic yield of EBUS-TBNA which was found to be high. Complications seem to be rare but such data are scant. We report three cases of complications including mediastinitis, pneumothorax and bleeding and provide a review on the existing literature.

Zusammenfassung

Die endobronchiale ultraschallgesteuerte transbronchiale Feinnadelaspiration (EBUS-TBNA) ist essenziell in der diagnostischen Aufarbeitung von Patienten mit Lungenkarzinom und anderen Lungenerkrankungen.

Der Schwerpunkt der vorhandenen Literatur zur EBUS-TBNA liegt in der Beurteilung ihrer diagnostischen Wertigkeit, welche als hoch eingeschätzt wird. Die Komplikationsraten erscheinen niedrig, jedoch ist die diesbezügliche Datenbasis schmal.

Wir berichten über jeweils einen Fall von Mediastinitis, Pneumothorax und Blutung nach EBUS-TBNA und geben einen Überblick über die aktuelle Literatur.

 

  • References

  • 1 Goeckenjan G. Sitter H. Thomas M. et al. Prevention, diagnosis, therapy, and follow-up of lung cancer: interdisciplinary guideline of the German Respiratory Society and the German Cancer Society. Pneumologie 2011; 65: 39-59
    Article in Thieme ConnectPubMedGoogle Scholar
  • 2 Silvestri GA. Gonzalez AV. Jantz MA. et al. Methods for staging non-small cell lung cancer: Diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest 2013; 143: e211S-250S
    CrossrefPubMedGoogle Scholar
  • 3 Gu P. Zhao YZ. Jiang LY. et al. Endobronchial ultrasound-guided transbronchial needle aspiration for staging of lung cancer: a systematic review and meta-analysis. Eur J Cancer 2009; 45: 1389-1396
    CrossrefPubMedGoogle Scholar
  • 4 Adams K. Shah PL. Edmonds L. et al. Test performance of endobronchial ultrasound and transbronchial needle aspiration biopsy for mediastinal staging in patients with lung cancer: systematic review and meta-analysis. Thorax 2009; 64: 757-762
    CrossrefPubMedGoogle Scholar
  • 5 Varela-Lema L. Fernandez-Villar A. Ruano-Ravina A. Effectiveness and safety of endobronchial ultrasound-transbronchial needle aspiration: a systematic review. Eur Respir J 2009; 33: 1156-1164
    CrossrefPubMedGoogle Scholar
  • 6 Yasufuku K. Pierre A. Darling G. et al. A prospective controlled trial of endobronchial ultrasound-guided transbronchial needle aspiration compared with mediastinoscopy for mediastinal lymph node staging of lung cancer. J Thorac Cardiovasc Surg 2011; 142: 1393-1400 e1391
    CrossrefPubMedGoogle Scholar
  • 7 Dhooria S. Aggarwal AN. Gupta D. et al. Utility and Safety of Endoscopic Ultrasound With Bronchoscope-Guided Fine-Needle Aspiration in Mediastinal Lymph Node Sampling: Systematic Review and Meta-Analysis. Respir Care 2015; 60: 1040-1050
    CrossrefPubMedGoogle Scholar
  • 8 Asano F. Aoe M. Ohsaki Y. et al. Complications associated with endobronchial ultrasound-guided transbronchial needle aspiration: a nationwide survey by the Japan Society for Respiratory Endoscopy. Respir Res 2013; 14: 50
    CrossrefPubMedGoogle Scholar
  • 9 Eapen GA. Shah AM. Lei X. et al. Complications, consequences, and practice patterns of endobronchial ultrasound-guided transbronchial needle aspiration: Results of the AQuIRE registry. Chest 2013; 143: 1044-1053
    CrossrefPubMedGoogle Scholar
  • 10 von Bartheld MB. Annema JT. Endosonography-related mortality and morbidity for pulmonary indications: a nationwide survey in the Netherlands. Gastrointest Endosc 2015; pii: S0016-5107(15)02283-X DOI: 10.1016/j.gie.2015.03.1973. [Epub ahead of print]
    CrossrefPubMedGoogle Scholar
  • 11 Motas N. Motas C. Achim D. et al. eComment. Fatal purulent mediastinitis after endobronchial ultrasound-guided transbronchial needle aspiration and mediastinoscopy. Interact Cardiovasc Thorac Surg 2013; 17: 752-753
    CrossrefPubMedGoogle Scholar
  • 12 Gochi F. Chen F. Aoyama A. et al. Mediastinal infectious complication after endobronchial ultrasound-guided transbronchial needle aspiration. Interact Cardiovasc Thorac Surg 2013; 17: 751-752
    CrossrefPubMedGoogle Scholar
  • 13 Kurimoto N. Shinmyo T. Tagay R. et al. A case of acute mediastinitis after endobronchial needle aspiration. Nihon Kokyuki Gakkai Zasshi 2011; 49: 588-591
    PubMedGoogle Scholar
  • 14 Leong SC. Marshall HM. Bint M. et al. Mediastinal abscess after endobronchial ultrasound-guided transbronchial needle aspiration: a case report and literature review. J Bronchology Interv Pulmonol 2013; 20: 338-341
    CrossrefPubMedGoogle Scholar
  • 15 Huang CT. Chen CY. Ho CC. et al. A rare constellation of empyema, lung abscess, and mediastinal abscess as a complication of endobronchial ultrasound-guided transbronchial needle aspiration. Eur J Cardiothorac Surg 2011; 40: 264-265
    CrossrefPubMedGoogle Scholar
  • 16 Moffatt-Bruce SD. Ross Jr P. Mediastinal abscess after endobronchial ultrasound with transbronchial needle aspiration: a case report. J Cardiothorac Surg 2009; 5: 33
    PubMedGoogle Scholar
  • 17 Parker KL. Bizekis CS. Zervos MD. Severe mediastinal infection with abscess formation after endobronchial ultrasound-guided transbrochial needle aspiration. Ann Thorac Surg 2010; 89: 1271-1272
    CrossrefPubMedGoogle Scholar
  • 18 McGovern Murphy F. Grondin-Beaudoin B. Poulin Y. et al. Mediastinal Abscess Following Endobronchial Ultrasound Transbronchial Needle Aspiration in a Patient With Sarcoidosis. J Bronchology Interv Pulmonol 2015; 22: 370-372
    CrossrefPubMedGoogle Scholar
  • 19 Haas AR. Infectious complications from full extension endobronchial ultrasound transbronchial needle aspiration. Eur Respir J 2009; 33: 935-938
    CrossrefPubMedGoogle Scholar
  • 20 Epstein SK. Winslow CJ. Brecher SM. et al. Polymicrobial bacterial pericarditis after transbronchial needle aspiration. Case report with an investigation on the risk of bacterial contamination during fiberoptic bronchoscopy. Am Rev Respir Dis 1992; 146: 523-525
    CrossrefPubMedGoogle Scholar
  • 21 Tachjian A. Shafer KM. Denkinger C. et al. Purulent pericarditis after transbronchial biopsy. Can J Cardiol 2014; 30: 1250 e1219-1221
    PubMedGoogle Scholar
  • 22 Lee HY. Kim J. Jo YS. et al. Bacterial pericarditis as a fatal complication after endobronchial ultrasound-guided transbronchial needle aspiration. Eur J Cardiothorac Surg 2015; 48: 630-632
    CrossrefPubMedGoogle Scholar
  • 23 Gamrekeli A. Kalweit G. Schäfer H. et al. Infection of a bronchogenic cyst after ultrasound-guided fine needle aspiration. Ann Thorac Surg 2013; 95: 2154-2155
    CrossrefPubMedGoogle Scholar
  • 24 Wang KP. Brower R. Haponik EF. et al. Flexible transbronchial needle aspiration for staging of bronchogenic carcinoma. Chest 1983; 84: 571-576
    CrossrefPubMedGoogle Scholar
  • 25 Kucera RF. Wolfe GK. Perry ME. Hemomediastinum after transbronchial needle aspiration. Chest 1986; 90: 466
    CrossrefPubMedGoogle Scholar
  • 26 Botana-Rial M. Nunez-Delgado M. Pallares-Sanmartin A. et al. Intramural hematoma of the pulmonary artery and hemopneumomediastinum after endobronchial ultrasound-guided transbronchial needle aspiration. Respiration 2012; 83: 353-356
    CrossrefPubMedGoogle Scholar
  • 27 Lazzari Agli L. Trisolini R. Burzi M. et al. Mediastinal hematoma following transbronchial needle aspiration. Chest 2002; 122: 1106-1107
    CrossrefPubMedGoogle Scholar
  • 28 Evison M. Crosbie PA. Martin J. et al. EBUS-TBNA in elderly patients with lung cancer: safety and performance outcomes. J Thorac Oncol 2014; 9: 370-376
    CrossrefPubMedGoogle Scholar
  • 29 Stather DR. Maceachern P. Chee A. et al. Trainee impact on advanced diagnostic bronchoscopy: an analysis of 607 consecutive procedures in an interventional pulmonary practice. Respirology 2013; 18: 179-184
    PubMedGoogle Scholar
  • 30 Okachi S. Imai N. Imaizumi K. et al. Endobronchial ultrasound transbronchial needle aspiration in older people. Geriatr Gerontol Int 2013; 13: 986-992
    CrossrefPubMedGoogle Scholar
  • 31 Giri S. Pathak R. Yarlagadda V. et al. Meta-analysis of 21- versus 22-G aspiration needle during endobronchial ultrasound-guided transbronchial needle aspiration. J Bronchology Interv Pulmonol 2015; 22: 107-113
    CrossrefPubMedGoogle Scholar
  • 32 Steinfort DP. Johnson DF. Irving LB. Incidence of bacteraemia following endobronchial ultrasound-guided transbronchial needle aspiration. Eur Respir J 2010; 36: 28-32
    CrossrefPubMedGoogle Scholar