1
|
Wimaleswaran H, Farmer MW, Irving LB, Jennings BR, Steinfort DP. Pulmonologist-performed transoesophageal sampling for lung cancer staging using an endobronchial ultrasound video-bronchoscope: an Australian experience. Intern Med J 2017; 47:205-210. [PMID: 27860078 DOI: 10.1111/imj.13330] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Revised: 10/16/2016] [Accepted: 11/03/2016] [Indexed: 12/25/2022]
Abstract
BACKGROUND Transoesophageal endobronchial ultrasound (EBUS) video-bronchoscope insertion provides pulmonologists access to conduct endoscopic fine-needle aspiration (EUS-B-FNA) of mediastinal lymph node (LN) lesions and also assist in lung cancer staging by sampling left adrenal gland (LAG) lesions. Limited literature has described additional diagnostic value whilst maintaining patient safety. To elicit whether combining endoscopic transoesophageal fine-needle aspiration using convex probe bronchoscope (EUS-B-FNA) and EBUS bronchoscopy enhances the diagnostic yield of mediastinal nodal staging in lung cancer, whilst maintaining safety. METHODS All eligible patients with paraoesophageal lesions on thoracic computed tomography (CT) underwent pulmonologist-performed EUS-B-FNA at two tertiary centres and were included in this prospective observational cohort study. RESULTS EUS-B-FNA sampling was performed at 69 mediastinal LN lesion sites, including 17 sites inaccessible to bronchoscopic sampling. Four LAG lesions were sampled via EUS-B-FNA. There were no complications. EBUS-TBNA was augmented by EUS-B-FNA because of accessibility of sampling lesions otherwise unamenable bronchoscopically, thereby increasing diagnostic utility. Diagnostic sensitivity of EUS-B-FNA for malignancy in mediastinal LN lesions was 88% (51 of 58). For mediastinal LN lesions not amenable to EBUS-TBNA, the sensitivity for diagnosis of malignancy via EUS-B-FNA was 88% (15 of 17). Diagnostic sensitivity of EUS-B-FNA for malignancy in LAG lesions was 50% (2 of 4). CONCLUSION EUS-B-FNA is a precise and safe approach in the evaluation and staging of lung cancer when performed by a pulmonologist. It complements and increases the diagnostic utility of EBUS-TBNA by further coverage of mediastinal LN stations and access to LAG lesions.
Collapse
Affiliation(s)
- Hari Wimaleswaran
- Deparment of Respiratory Medicine, Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - Michael W Farmer
- Department of Respiratory and Sleep Medicine, Monash Medical Centre, Melbourne, Victoria, Australia
| | - Louis B Irving
- Deparment of Respiratory Medicine, Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - Barton R Jennings
- Department of Respiratory and Sleep Medicine, Monash Medical Centre, Melbourne, Victoria, Australia
| | - Daniel P Steinfort
- Deparment of Respiratory Medicine, Royal Melbourne Hospital, Melbourne, Victoria, Australia.,Department of Medicine, The University of Melbourne, Melbourne, Victoria, Australia
| |
Collapse
|
2
|
Meena N, Hulett C, Patolia S, Bartter T. Exploration under the dome: Esophageal ultrasound with the ultrasound bronchoscope is indispensible. Endosc Ultrasound 2016; 5:254-7. [PMID: 27503158 PMCID: PMC4989407 DOI: 10.4103/2303-9027.187886] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Background: Effective use of the convex curvilinear ultrasound bronchoscope in the esophagus (EUS-B) for fine needle aspiration biopsy of mediastinal structures is now well described. In contrast, there is little to no reporting, depending on the site of EUS-B for access to sub-diaphragmatic structures. Our practice has been accessing sub-diaphragmatic sites for years. This review documents our experience with EUS-B to biopsy liver, left adrenal glands, and coeliac lymph nodes. Methods: After Institutional Review Board's approval, all endosonographic procedures performed by interventional pulmonary between July 2013 and June 2015 were reviewed. Those including biopsy of sub-diaphragmatic sites were then selected for analysis. Results: Over the study interval, 45 sub-diaphragmatic biopsy procedures (25 left adrenal glands, 7 liver, and 13 celiac node) were performed with EUS-B. In all cases, cellular adequacy was present, and samples were large enough for immunohistochemistry and any relevant ancillary studies. Metastatic malignancy was documented in 58% of cases, 16% of cases contained benign diagnostic findings, and in 27% of cases, normal organ tissue was documented. There were no complications. Conclusions: Operators comfortable with the endobronchial ultrasound scope in both the airway and the esophagus can actively seek and successfully perform biopsy of sub-diaphragmatic abnormalities when present and can thereby add to the diagnostic value of the procedure.
Collapse
Affiliation(s)
- Nikhil Meena
- Department of Medicine, Central Arkansas Veterans Healthcare System, University of Arkansas for Medical Sciences, AR, USA
| | - Cidney Hulett
- Department of Internal Medicine, CHI St. Vincent Infirmary, Little Rock, AR, USA
| | - Setu Patolia
- Department of Internal Medicine, St. Louis University, St. Louis, MO, USA
| | - Thaddeus Bartter
- Department of Medicine, Central Arkansas Veterans Healthcare System, University of Arkansas for Medical Sciences, AR, USA
| |
Collapse
|
3
|
Steinhauser Motta JP, Kempa AT, Pinto Cardoso A, Paschoal ME, Raggio Luiz R, Lapa E Silva JR, Stanzel F. Endobronchial ultrasound in real life: primary diagnosis and mediastinal staging of lung cancer in patients submitted to thoracic surgery. BMC Pulm Med 2016; 16:101. [PMID: 27435209 PMCID: PMC4952060 DOI: 10.1186/s12890-016-0264-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2016] [Accepted: 07/07/2016] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Since the first articles published for over 10 years ago, endobronchial ultrasound (EBUS) has gained a strong scientific backing and has been incorporated into routine medical practice in pulmonology and thoracic surgery centers. How is EBUS performing outside the scientific environment, as a diagnostic and mediastinal staging tool in a subset of patients that undergo thoracic surgery, is an interesting question. METHODS This study evaluated consecutive patients who, during the period from January 2010 to August 2012, were submitted to EBUS and later to thoracic surgery. The samples obtained by endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) were compared to surgical samples. The primary endpoint was the proportion of patients with a final diagnosis of non-small cell lung cancer (NSCLC) by EBUS-TBNA correctly subtyped. The secondary endpoint was the negative predictive value (NPV) of EBUS-TBNA for mediastinal staging of lung cancer. RESULTS Two hundred eighty seven patients were studied. Considering 84 patients with a final diagnosis of NSCLC by EBUS-TBNA, 79 % (CI 95 % 70.1-87.3) were correctly subclassified. The NPV of EBUS-TBNA for mediastinal staging was 89 % (IC 95 % 84.9-92.7). From a total of 21 false negative cases of mediastinal staging, 16 (76 %) did not undergo positron emission tomography-computed tomography (PET-CT) before the EBUS and in 15 (71 %) the affected lymph node chain was not punctured by EBUS-TBNA. Ten (47 %) patients had only lymph node metastases not directly accessible by the EBUS. CONCLUSIONS Performed in hospital routine and in patients submitted to thoracic surgery, EBUS-TBNA proved to be a good tool for proper pathological diagnosis of lung cancer. The negative predictive value of 89 % for mediastinal staging of lung cancer is comparable to that reported in previous studies, but the relatively high number of 21 false negative cases points to the need for standardization of routine strategies before, during and after EBUS.
Collapse
Affiliation(s)
- João Pedro Steinhauser Motta
- Instituto de Doenças do Torax, Universidade Federal do Rio de Janeiro, Rua Professor Rodolpho Paulo Rocco, 255, 1 andar, sala 01D 58/60, Rio de Janeiro, RJ, 21941-913, Brazil.
| | | | - Alexandre Pinto Cardoso
- Instituto de Doenças do Torax, Universidade Federal do Rio de Janeiro, Rua Professor Rodolpho Paulo Rocco, 255, 1 andar, sala 01D 58/60, Rio de Janeiro, RJ, 21941-913, Brazil
| | - Marcos Eduardo Paschoal
- Instituto de Doenças do Torax, Universidade Federal do Rio de Janeiro, Rua Professor Rodolpho Paulo Rocco, 255, 1 andar, sala 01D 58/60, Rio de Janeiro, RJ, 21941-913, Brazil
| | - Ronir Raggio Luiz
- Instituto de Estudos em Saúde Coletiva, Universidade Federal do Rio de Janeiro, Avenida HorácioMacedo, lha do Fundão - Cidade Universitária, 21941-598, Rio de Janeiro, RJ, Brazil
| | - José Roberto Lapa E Silva
- Instituto de Doenças do Torax, Universidade Federal do Rio de Janeiro, Rua Professor Rodolpho Paulo Rocco, 255, 1 andar, sala 01D 58/60, Rio de Janeiro, RJ, 21941-913, Brazil
| | - Franz Stanzel
- Lungenklinik Hemer, Theo-Funccius-Straße 1, 58675, Hemer, NW, Germany
| |
Collapse
|
4
|
Sharma M, Ecka RS, Somasundaram A, Shoukat A, Kirnake V. Endoscopic ultrasound in mediastinal tuberculosis. Lung India 2016; 33:129-34. [PMID: 27051097 PMCID: PMC4797428 DOI: 10.4103/0970-2113.177451] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Background: Tubercular lymphadenitis is the commonest extra pulmonary manifestation in cervical and mediastinal locations. Normal characteristics of lymph nodes (LN) have been described on ultrasonography as well as by Endoscopic Ultrasound. Many ultrasonic features have been described for evaluation of mediastinal lymph nodes. The inter and intraobserver agreement of the endosonographic features have not been uniformly established. Methods and Results: A total of 266 patients underwent endoscopic ultrasound guided fine needle aspiration and 134 cases were diagnosed as mediastinal tuberculosis. The endoscopic ultrasound location and features of these lymph nodes are described. Conclusion: Our series demonstrates the utility of endoscopic ultrasound guided fine needle aspiration as the investigation of choice for diagnosis of mediastinal tuberculosis and also describes various endoscopic ultrasound features of such nodes.
Collapse
Affiliation(s)
- Malay Sharma
- Department of Gastroenterology, Jaswant Rai Speciality Hospital, Saket, Meerut, Uttar Pradesh, India
| | - Ruth Shifa Ecka
- Department of Gastroenterology, Jaswant Rai Speciality Hospital, Saket, Meerut, Uttar Pradesh, India
| | - Aravindh Somasundaram
- Department of Gastroenterology, Kovai Medical Center and Hospital, Coimbatore, Tamil Nadu, India
| | - Abid Shoukat
- Department of Gastroenterology, Jaswant Rai Speciality Hospital, Saket, Meerut, Uttar Pradesh, India
| | - Vijendra Kirnake
- Department of Gastroenterology, Jaswant Rai Speciality Hospital, Saket, Meerut, Uttar Pradesh, India
| |
Collapse
|
5
|
Meena N, Bartter T. Endosonography for mediastinal disease: esophageal ultrasound vs. endobronchial ultrasound. Endosc Int Open 2015; 3:E302-6. [PMID: 26357674 PMCID: PMC4554500 DOI: 10.1055/s-0034-1392092] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2014] [Accepted: 03/23/2015] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND AND STUDY AIMS One can approach mediastinal pathology via esophageal ultrasound (EUS) and/or endobronchial ultrasound (EBUS). It has been suggested that EUS is better tolerated by patients. If so, EUS might be the procedure of choice when suspect lesions are accessible via EUS. We studied procedural characteristics of EUS with fine needle aspiration (EUS-FNA) and EBUS with transbronchial needle aspiration (EBUS-TBNA) to see how they differed. PATIENTS AND METHODS Retrospective review of consecutive EBUS and EUS procedures performed on patients over nine months. One hundred fifty-five procedures were analyzed (61 EUS, 73 EBUS, 21 EUS + EBUS). For EUS, EBUS, and EUS + EBUS, 1.4, 2.0 and 2.5 sites (mean) were sampled, respectively. EUS required approximately one-half of the time of EBUS or the combined procedures; 13.1 vs. 24.1 and 26.9 min, respectively (P < 0.0001 for EUS vs. both EBUS and EUS + EBUS). Sedation dosing was statistically lower for EUS and not significantly different between EBUS and the combined approach. EUS also involved lower oxygen requirements and shorter time to discharge. Because fewer mean sites were sampled with EUS than with EBUS or the combined procedure, we performed analysis restricted to procedures that involved sampling of ≤ 2 sites to determine whether approach-related differences in procedure characteristics were preserved. There were 56 such EUS procedures and 52 such EBUS procedures. EUS remained significantly faster and required less patient sedation. CONCLUSIONS EUS involved statistically significant economies of time and sedation. This has implications with respect to safety and productivity. When applicable, EUS is the procedure of choice.
Collapse
Affiliation(s)
- Nikhil Meena
- University of Arkansas for Medical Sciences and Central Arkansas Veterans Healthcare System, Little Rock, Arkansas, United States,Corresponding author Dr. Nikhil Meena University of Arkansas for Medical Sciences4301 W. Markham Mail Slot #555Little Rock, Arkansas 72205United States+1-501-686-7893
| | - Thaddeus Bartter
- University of Arkansas for Medical Sciences and Central Arkansas Veterans Healthcare System, Little Rock, Arkansas, United States
| |
Collapse
|
6
|
Oki M, Saka H, Ando M, Tsuboi R, Nakahata M, Oka S, Kogure Y, Kitagawa C. Transbronchial vs transesophageal needle aspiration using an ultrasound bronchoscope for the diagnosis of mediastinal lesions: a randomized study. Chest 2015; 147:1259-1266. [PMID: 25275701 DOI: 10.1378/chest.14-1283] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND The purpose of this study was to compare the tolerance, efficacy, and safety of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) with transesophageal endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) with an endobronchial ultrasound scope for the first pathologic diagnosis of lesions accessible by both procedures. METHODS Patients who had lesions accessible by both EBUS-TBNA and EUS-FNA were enrolled and were randomized to undergo either procedure. Patients quantified tolerance, and operators charted the quality of examination using a 100-mm visual analog scale (VAS). RESULTS A specific diagnosis was made in 50 of 55 patients (91%) in the EBUS-TBNA group and in 48 of 55 patients (87%) in the EUS-FNA group (P = .76). Compared with EBUS-TBNA, EUS-FNA was associated with a shorter duration of procedure (median, 15.3 min vs 11.3 min; P < .001), lower doses of IV midazolam (mean, 4.4 mg vs 4 mg; P = .02) and intraairway lidocaine (mean, 303 mg vs 189 mg; P < .001), less frequent oxygen desaturations (23 of 55 vs two of 55, P < .001), and higher operator satisfaction (P < .001). There was no significant difference in patient tolerance according to the patients' VAS. Lymph node infection occurred in one patient in the EBUS-TBNA group and in two patients in the EUS-FNA group. CONCLUSIONS Both EBUS-TBNA and EUS-FNA provide high accuracy with good tolerance, although the occurrence of infectious complications should be monitored carefully. EUS-FNA has the advantage of comparable tolerance with fewer doses of anesthetics and sedatives, a shorter procedure time, and fewer oxygen desaturations during the procedure. TRIAL REGISTRY UMIN Clinical Trials Registry; No.: UMIN000005757; URL: http://www.umin.ac.jp/ctr/.
Collapse
Affiliation(s)
- Masahide Oki
- Department of Respiratory Medicine, Nagoya Medical Center, Nagoya University Hospital, Nagoya, Japan.
| | - Hideo Saka
- Department of Respiratory Medicine, Nagoya Medical Center, Nagoya University Hospital, Nagoya, Japan
| | - Masahiko Ando
- Center for Advanced Medicine and Clinical Research, Nagoya University Hospital, Nagoya, Japan
| | - Rie Tsuboi
- Department of Respiratory Medicine, Nagoya Medical Center, Nagoya University Hospital, Nagoya, Japan
| | - Masashi Nakahata
- Department of Respiratory Medicine, Nagoya Medical Center, Nagoya University Hospital, Nagoya, Japan
| | - Saori Oka
- Department of Respiratory Medicine, Nagoya Medical Center, Nagoya University Hospital, Nagoya, Japan
| | - Yoshihito Kogure
- Department of Respiratory Medicine, Nagoya Medical Center, Nagoya University Hospital, Nagoya, Japan
| | - Chiyoe Kitagawa
- Department of Respiratory Medicine, Nagoya Medical Center, Nagoya University Hospital, Nagoya, Japan
| |
Collapse
|
7
|
Gasparini S, Bonifazi M. Bronchoscope: beyond the thorax! ACTA ACUST UNITED AC 2015; 89:17-8. [PMID: 25592827 DOI: 10.1159/000370127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- Stefano Gasparini
- Department of Biomedical Sciences and Public Health, Università Politecnica delle Marche, Ancona, Italy
| | | |
Collapse
|
8
|
Sharma M. The route of FNA for mediastinal nodes, ′to each his own′. Lung India 2015. [DOI: 10.4103/0970-2113.148460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
9
|
Meena N, Hulett C, Jeffus S, Bartter T. Left adrenal biopsy using the convex curvilinear ultrasound scope. ACTA ACUST UNITED AC 2014; 89:57-61. [PMID: 25502409 DOI: 10.1159/000368370] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2014] [Accepted: 09/02/2014] [Indexed: 11/19/2022]
Abstract
Effective use of the convex curvilinear ultrasound bronchoscope in the esophagus (EUS-B) is well described. EUS-B has not been described for diagnostic sampling of the left adrenal gland. We describe 6 cases of diagnostic fine-needle aspiration of the left adrenal gland using EUS-B. This capacity increases the diagnostic capabilities of the pulmonologist experienced in EUS-B.
Collapse
Affiliation(s)
- Nikhil Meena
- Department of Medicine, University of Arkansas for Medical Sciences, Little Rock, Ark., USA
| | | | | | | |
Collapse
|
10
|
[Advances in respiratory health 2010: Techniques and Transplantation Section]. Arch Bronconeumol 2014; 47 Suppl 1:36-40. [PMID: 21300217 DOI: 10.1016/s0300-2896(11)70010-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Five articles and an editorial on interventional pneumology were published in Archivos de Bronconeumología. Two of these articles deal with bronchoscopy, one with lung biopsy with cryoprobes, one with thermoplasty in asthma and the last with tracheobronchomalacia. We also review several publications in international journals, with special emphasis on endobronchial ultrasound. Four original articles on idiopathic pulmonary fibrosis were published in Archivos de Bronconeumología: one special article comparing two treatments and a Cochrane systematic review on the efficacy of non-steroidal drugs in this disease. Finally, we highlight studies in lung transplantation, consisting of 14 publications from different continents and with highly diverse contents: one editorial, one letter to the editor, one procedures manual and nine international publications on donor characteristics, various types of complications, experimental results in the field of preservation, and the casuistics obtained in distinct diseases in which transplantation is an option.
Collapse
|
11
|
Kang HJ, Hwangbo B, Lee GK, Nam BH, Lee HS, Kim MS, Lee JM, Zo JI, Lee HS, Han JY. EBUS-centred versus EUS-centred mediastinal staging in lung cancer: a randomised controlled trial. Thorax 2013; 69:261-8. [DOI: 10.1136/thoraxjnl-2013-203881] [Citation(s) in RCA: 77] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
|
12
|
|
13
|
Oki M, Saka H, Kitagawa C, Kogure Y, Murata N, Adachi T, Ichihara S, Moritani S. Transesophageal Bronchoscopic Ultrasound-Guided Fine Needle Aspiration for Diagnosis of Sarcoidosis. Respiration 2013; 85:137-43. [DOI: 10.1159/000345207] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2012] [Accepted: 10/02/2012] [Indexed: 01/09/2023] Open
|
14
|
[Role of endoscopic ultrasound (EUS) and endobronchial ultrasound (EBUS) for the evaluation of mediastinal adenopathy]. Bull Cancer 2012; 99:761-70. [PMID: 22713588 DOI: 10.1684/bdc.2012.1606] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Mediastinal lymphadenopathy may be detected by CT-scan or positron emission tomography. Malignant (e.g, lung cancer, metastatic cancer, lymphoma), infectious (e.g, tuberculosis, histoplasmosis), and systemic processes (e.g, sarcoidosis) can cause mediastinal adenopathy. In the posterior and inferior mediastinum, endoscopic ultrasound visualizes and directs transesophageal fine needle aspiration of adenopathy. In the anterior mediastinum, endobronchial ultrasound visualizes and directs transbronchial fine needle aspiration of adenopathy. We discuss the role of EUS and EBUS in the evaluation of mediastinal adenopathy according to their anatomical localization.
Collapse
|
15
|
Annema JT. Endobronchial Ultrasound and Esophageal Ultrasound: Response. Chest 2011. [DOI: 10.1378/chest.11-0657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
|
16
|
Wang KP, Feller-Kopman D, Mehta A, Sharma M, Yarmus L. Endobronchial Ultrasound and Esophageal Ultrasound. Chest 2011; 140:271-272. [DOI: 10.1378/chest.11-0171] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
|
17
|
Franco J, Monclou E. [Transesophageal endobronchial ultrasound-guided fine-needle aspiration]. Arch Bronconeumol 2011; 47:418-9. [PMID: 21524836 DOI: 10.1016/j.arbres.2011.02.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2011] [Accepted: 02/28/2011] [Indexed: 11/25/2022]
|