{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T06:27:04Z","timestamp":1792650424562,"version":"4.5.0"},"reference-count":35,"publisher":"SAGE Publications","issue":"7","license":[{"start":{"date-parts":[[2015,7,1]],"date-time":"2015-07-01T00:00:00Z","timestamp":1435708800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Respir Care"],"published-print":{"date-parts":[[2015,7]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>The use of endoscopic ultrasound with bronchoscope-guided fine-needle aspiration (EUS-B-FNA) has been described in the evaluation of mediastinal lymphadenopathy. Herein, we conduct a meta-analysis to estimate the overall diagnostic yield and safety of EUS-B-FNA combined with endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA), in the diagnosis of mediastinal lymphadenopathy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>The PubMed and EmBase databases were searched for studies reporting the outcomes of EUS-B-FNA in diagnosis of mediastinal lymphadenopathy. The study quality was assessed using the QualSyst tool. The yield of EBUS-TBNA alone and the combined procedure (EBUS-TBNA and EUS-B-FNA) were analyzed by calculating the sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio for each study, and pooling the study results using a random effects model. Heterogeneity and publication bias were assessed for individual outcomes. The additional diagnostic gain of EUS-B-FNA over EBUS-TBNA was calculated using proportion meta-analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>\n                      Our search yielded 10 studies (1,080 subjects with mediastinal lymphadenopathy). The sensitivity of the combined procedure was significantly higher than EBUS-TBNA alone (91% vs 80%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .004), in staging of lung cancer (4 studies, 465 subjects). The additional diagnostic gain of EUS-B-FNA over EBUS-TBNA was 7.6% in the diagnosis of mediastinal adenopathy. No serious complication of EUS-B-FNA procedure was reported. Clinical and statistical heterogeneity was present without any evidence of publication bias.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>Combining EBUS-TBNA and EUS-B-FNA is an effective and safe method, superior to EBUS-TBNA alone, in the diagnosis of mediastinal lymphadenopathy. Good quality randomized controlled trials are required to confirm the results of this systematic review.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4187\/respcare.03779","type":"journal-article","created":{"date-parts":[[2015,3,10]],"date-time":"2015-03-10T23:26:59Z","timestamp":1426030019000},"page":"1040-1050","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":90,"title":["Utility and Safety of Endoscopic Ultrasound With Bronchoscope-Guided Fine-Needle Aspiration in Mediastinal Lymph Node Sampling: Systematic Review and Meta-Analysis"],"prefix":"10.1177","volume":"60","author":[{"given":"Sahajal","family":"Dhooria","sequence":"first","affiliation":[{"name":"Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashutosh N","family":"Aggarwal","sequence":"additional","affiliation":[{"name":"Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dheeraj","family":"Gupta","sequence":"additional","affiliation":[{"name":"Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Digambar","family":"Behera","sequence":"additional","affiliation":[{"name":"Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ritesh","family":"Agarwal","sequence":"additional","affiliation":[{"name":"Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2015,7,1]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF00316842"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.126.1.122"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.rmed.2012.02.014"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.13-2339"},{"issue":"4","key":"e_1_3_2_6_2","first-page":"803","article-title":"Initial experience with real time endobronchial ultrasound guided transbronchial needle aspiration from a tertiary care hospital in north India","volume":"137","author":"Srinivasan A","year":"2013","unstructured":"Srinivasan A, , Agarwal R, , Gupta N, , Aggarwal AN, , Gupta D. Initial experience with real time endobronchial ultrasound guided transbronchial needle aspiration from a tertiary care hospital in north India. Indian J Med Res, 2013; 137(4):803\u2013807.","journal-title":"Indian J Med Res"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-2006-946671"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00013806"},{"issue":"4","key":"e_1_3_2_9_2","first-page":"331","article-title":"The complete medical mediastinoscopy (EUS-FNA + EBUS-TBNA)","volume":"98","author":"Vilmann P","year":"2007","unstructured":"Vilmann P, , Puri R. The complete medical mediastinoscopy (EUS-FNA + EBUS-TBNA). 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