{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T16:56:01Z","timestamp":1781801761725,"version":"3.54.5"},"reference-count":13,"publisher":"S. Karger AG","license":[{"start":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T00:00:00Z","timestamp":1775520000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/karger.com\/pages\/terms-and-conditions"},{"start":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T00:00:00Z","timestamp":1775520000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/karger.com\/pages\/terms-and-conditions"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Respiration"],"abstract":"<jats:p>Introduction: Endobronchial ultrasound transbronchial needle aspiration (EBUS-TBNA) is the standard for mediastinal and hilar lymph node sampling. Traditionally, a single needle is used, which can lead to procedural downtime while specimens are processed, potentially prolonging anesthesia duration. This study aimed to determine whether using a second needle could expedite the procedure enough to offset its cost. Methods: In a prospective, single-blind, multi-center, randomized controlled trial, 126 adult patients undergoing EBUS-TBNA were randomized to either 1 or 2 needles. The primary outcome was time per needle pass. Secondary outcomes included cost-benefit analysis, diagnostic yield, next-generation sequencing (NGS) sufficiency, and carbon impact. Results: The two-needle group had significantly faster needle passes (56.2 \u00b1 14.3 vs. 82.1 \u00b1 21.9 s; p &lt; 0.001), though total procedure time was not significantly different (22.2 \u00b1 9.1 vs. 24.7 \u00b1 12.5 min; p = 0.101). More needle passes were performed in the two-needle group (16.9 \u00b1 6.5 vs. 13.9 \u00b1 6.1; p = 0.004), with no difference in the number of lymph nodes sampled. Diagnostic yield was 96.0% overall, and NGS sufficiency in cancer cases was 93.6%, with no differences between groups. Conclusion: Using a second needle decreases time per needle pass without changing overall procedure time or compromising diagnostic performance. Although it increases immediate cost and environmental impact, a customizable model was developed to help centers determine when the time savings justify the added expense, based on anesthesia cost, needle price, and planned passes per node.<\/jats:p>","DOI":"10.1159\/000551855","type":"journal-article","created":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T16:00:59Z","timestamp":1775577659000},"page":"1-9","source":"Crossref","is-referenced-by-count":0,"title":["Study of Procedural Efficiency in Endobronchial Ultrasound with Dual versus Single NEEDLEs: Evaluating the Value of a Second Needle in Endobronchial Ultrasound as It Pertains to Economic and Environmental Impact"],"prefix":"10.1159","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1269-2326","authenticated-orcid":false,"given":"Christopher M.","family":"Kapp","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeremy J.","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Coral","family":"Giovacchini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jamie H.","family":"Rowell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chinh","family":"Phan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donald Scott","family":"Slusarenko","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"Salmon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kamran","family":"Mahmood","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca P.","family":"Kirby","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Momen M.","family":"Wahidi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"Interventional Pulmonary Outcomes Group (IPOG)","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"127","published-online":{"date-parts":[[2026,4,7]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1016\/j.chest.2024.05.026"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-2600(15)00029-6"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1016\/j.chest.2018.10.020"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2016.12.048"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.21037\/jtd.2017.03.102"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1016\/j.lungcan.2022.01.018"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2017.6233"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1378\/chest.15-1216"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2008.08.010"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.202401-0192ST"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1097\/JTO.0000000000000388"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2011.08.037"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1177\/17534666241277668"}],"container-title":["Respiration"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/karger.com\/article-pdf\/doi\/10.1159\/000551855","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T16:01:27Z","timestamp":1781798487000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/000551855"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,7]]},"references-count":13,"URL":"https:\/\/doi.org\/10.1159\/000551855","archive":["Portico"],"relation":{"is-supplemented-by":[{"id-type":"doi","id":"10.6084\/m9.figshare.31939785","asserted-by":"subject"}]},"ISSN":["0025-7931","1423-0356"],"issn-type":[{"value":"0025-7931","type":"print"},{"value":"1423-0356","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,7]]}}}