Na 2015x 4022

All procedures were performed with rigid bronchoscopy and jet ventilation under general anesthesia. The EBUS-TBNA examination was performed with an EBUS-TBNA bronchoscope (BF-UC 180F; Olympus Corporation, Tokyo, Japan) and all mediastinal and hilar lymph node stations were assessed systematically and punctured with a 22-gauge needle (NA-2015X-4022; Olympus Corporation) if their diameter exceeded 10 mm. After the needle was passed in the lymph node under ultrasound guidance, the internal stylet was retracted halfway and the needle was advanced back and forth to obtain further tissue aspirates. No additional vacuum was applied. The number of passes was decided by the bronchoscopist based on the amount of obtained biopsy material. No additional suction was applied.

EBUS-TBNA was performed by 2 trained operators using a curvilinear scanning ultrasound bronchoscope (BF UC260F-OL8, Olympus Ltd., Tokyo, Japan) connected to an ultrasound unit (EU-C60 Olympus Ltd., Tokyo, Japan). For paratracheal lesions, the scope was positioned endotracheally. For peribronchial lesions the scope was positioned in the respective bronchi in order to visualize the lung lesion. TBNA was performed using a 22-gauge needle (NA-2015X-4022, Olympus Ltd., Tokyo, Japan). Two aspirates were performed with 15 revolutions (moving needle back and forth in the lesion) per aspirate. The core tissue was expelled onto piece of paper for histological examination and the needle was flushed with saline onto glass slides for cytological examination. The aspirate was smeared onto glass slides, air dried, fixed immediately with 95% alcohol. Histological cores were fixed with 10% neutral buffered formalin. Rapid on-site cytological examination was not available. A postprocedure chest X-ray was routinely performed to exclude any procedure-related complications.^{[13 (link)]}