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Rev Mal Respir ; 41(8): 549-561, 2024 Oct.
Artigo em Francês | MEDLINE | ID: mdl-39179425

RESUMO

INTRODUCTION: While mediastinoscopy is considered the gold standard for mediastinal node sampling, it is to some extent being superseded by endobronchial ultrasound. The objective of this study was to evaluate the different practices in our center regarding mediastinal lymph node sampling in lung cancer patients. METHODS: Data were collected from patients having undergone mediastinal lymph node sampling by video-assisted-mediastinoscopy (VM) or by endobronchial ultrasound (EBUS) in our center between August 2020 and July 2023. The modalities of the two procedures and their diagnostic accuracy were analyzed, as was their evolution over time. RESULTS: The 362 patients comprised 217 who were sampled by EBUS and 145 by VM. Overall, the procedures became more frequent, with EBUS tending to supersede VM. The number of harvested lymph nodes gradually grew, and less unforeseen lymph node invasion and upstaging occurred. CONCLUSION: The arrival in our center of endobronchial ultrasound yielded an overall increase of lymph node sampling despite a decrease in the number of mediastinoscopy procedures performed. Reinforced compliance with guidelines is needed to improve the diagnostic accuracy of these techniques and to better ensure quality of care.


Assuntos
Neoplasias Pulmonares , Linfonodos , Metástase Linfática , Mediastinoscopia , Mediastino , Humanos , Neoplasias Pulmonares/patologia , Neoplasias Pulmonares/diagnóstico , Linfonodos/patologia , Linfonodos/diagnóstico por imagem , Mediastinoscopia/métodos , Mediastino/patologia , Mediastino/diagnóstico por imagem , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Metástase Linfática/diagnóstico , Metástase Linfática/patologia , Estudos Retrospectivos , Endossonografia/métodos , Endossonografia/normas , Adulto , Idoso de 80 Anos ou mais , Padrões de Prática Médica/estatística & dados numéricos , Padrões de Prática Médica/normas , Padrões de Prática Médica/tendências , Broncoscopia/métodos , Broncoscopia/estatística & dados numéricos , Broncoscopia/normas , Excisão de Linfonodo/métodos
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