期刊
CHEST
卷 128, 期 2, 页码 869-875出版社
ELSEVIER
DOI: 10.1378/chest.128.2.869
关键词
bronchoscopy; cancer diagnosis; transbronchial needle aspiration
Study objective: To determine the extent to which rapid on-site cytologic evaluation (ROSE) of transbronchial needle aspiration (TBNA) samples can safely and cost-effectively reduce the need for additional biopsy during bronchoscopy. Setting: University Hospital in Long Island, NY. Patient and methods: Forty-four bronchoscopies with TBNA, most of which utilized ROSE, were evaluated prospectively. The number and types of biopsies performed during each procedure were compared to a preprocedural algorithm to determine the impact of knowing ROSE results during the procedure. Bronchoscopies performed with and without ROSE were compared, as were bronchoscopies with diagnostic and nondiagnostic ROSE results. A cost analysis was performed comparing the Medicare reimbursement for ROSE to the savings of deferring multiple biopsies. Results: Thirty-two bronchoscopies were performed with ROSE; 12 were performed without ROSE. Fewer biopsies were performed during bronchoscopies utilizing ROSE. Diagnostic yield, TBNA sensitivity and accuracy, and procedural time were similar between these two groups. Conclusions: ROSE during TBNA allows for deferring additional biopsy without loss in diagnostic yield, likely lowers procedural risk, and is cost-effective.
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