Learning Curve of Conventional Transbronchial Needle Aspiration

Tutar N., Büyükoğlan H., Yılmaz İ., KANBAY A. , Önal O., Bilgin M., ...More

CLINICAL RESPIRATORY JOURNAL, vol.8, no.1, pp.79-85, 2013 (Journal Indexed in SCI Expanded)

  • Publication Type: Article / Article
  • Volume: 8 Issue: 1
  • Publication Date: 2013
  • Page Numbers: pp.79-85



Intrathoracic lymphadenopathy usually occurs as a result of neoplasm, granulomatous diseases, infections or reactive hyperplasia. Conventional transbronchial needle aspiration (C-TBNA) is a cheap and safe procedure for diagnosing intrathoracic lymphadenopathy.


The aim of this study was to assess the learning curve and diagnostic accuracy of C-TBNA after an observational education program.


In the present study, we retrospectively evaluated our first 62 C-TBNA procedures at Erciyes University between May 2012 and December 2012 after an observational education program. The first 31 patients were defined as group A, and the second 31 patients as group B.


One hundred and seven lymph nodes were sampled in 62 patients by C-TBNA. Adequate lymph node samples were obtained in 52 of the 62 patients (83.8%). In these 52 patients, two patients had a diagnosis of "suspicious of malignancy" by C-TBNA and these patients were excluded from the analysis. In the remaining 50 cases who had adequate results, the sensitivity, specificity, PPV, NPV and diagnostic accuracy per patient were 80.6%, 92.9%, 96.7%, 65.0% and 84.0% respectively. The diagnostic accuracy rates of C-TBNA for Group A and B were 72.0% (18 / 25 ) and 96.0 % (24 / 25) and the difference was statistically significant (p<0.05).


C-TBNA is a useful diagnostic procedure for sampling intrathoracic lymphadenopathies and masses which are adjacent to the bronchial system. An observational education program is helpful for learning C-TBNA. The diagnostic yield improves in time and approximately 30 procedures may be sufficient to achieve successful results.