Sahajal Dhooria, Inderpaul Singh Sehgal, Nalini Gupta, Babu Ram, Ashutosh Nath Aggarwal, Digambar Behera, Ritesh Agarwal
BACKGROUND: Endobronchial ultrasound (EBUS)-guided transbronchial needle aspiration (TBNA) requires a dedicated needle for aspiration of mediastinal lesions. There is no data on reuse of these needles.
METHODS: This is a retrospective study of patients who underwent EBUS-TBNA with either new or reused EBUS-TBNA needles. The needles were reused after thorough cleaning with filtered water and organic cleaning solution, disinfection with 2.4% glutaraldehyde solution followed by ethylene oxide sterilization. The yield of EBUS-TBNA was compared between the two groups.
RESULTS: A total of 500 EBUS-TBNA procedures (351 new, 149 reused needles) were performed. The baseline characteristics were different in the two groups with suspected granulomatous disorders (sarcoidosis or tuberculosis) being significantly more common in the new compared to the reused needle group. Similarly, the median, interquartile range number of lymph node stations sampled, and the total number of passes were significantly higher in the new versus the reused needle group. The diagnostic yield was significantly higher with new needle as compared to reused needle (65.2% vs. 53.7%, P = 0.02). On multivariate logistic regression analysis, clinical suspicion of granulomatous disorders (odds ratio 1.86 [95% confidence interval, 1.20-2.87], P = 0.005) was the only predictor of diagnostic yield, after adjusting for the type of needle (new or reused), total number of passes and the number of lymph node stations sampled. No case of mediastinitis was encountered in either group.
CONCLUSIONS: The yield of EBUS-TBNA might be similar with single reuse of needles as compared to new needles. However, reuse of needle should be performed only when absolutely necessary.
