Safety and Costs of Endobronchial Ultrasound-Guided Nodal Aspiration and Mediastinoscopy.

Safety and Costs of Endobronchial Ultrasound-Guided Nodal Aspiration and Mediastinoscopy. Chest. 2019 Oct 09;: Authors: Verdial FC, Berfield K, Wood DE, Mulligan M, Roth J, Francis DO, Farjah F Abstract BACKGROUND: There remains debate over the best invasive diagnostic modality for mediastinal nodal evaluation. Prior studies have limited generalizability and insufficient power to detect differences in rare adverse events. We compared the risks and costs of endobronchial ultrasound-guided nodal aspiration (EBUS) and mediastinoscopy performed for any indication in a large national cohort. METHODS: We conducted a retrospective study (2007-2015) using MarketScan-a claims database of individuals with employer-provided insurance in the United States. Patients who underwent multi-modality mediastinal evaluation (n=1,396) or same-day pulmonary resection (n=2,130) were excluded. Regression models were used to evaluate associations between diagnostic modalities and risks and costs while adjusting for patient characteristics, year, concomitant bronchoscopic procedures, and lung cancer diagnosis. RESULTS: Among 30,570 patients, 49% underwent EBUS. Severe adverse events-pneumothorax, hemothorax, airway/vascular injuries, or death-were rare and invariant between EBUS and mediastinoscopy (0.3% versus 0.4%, p=0.189). The rate of vocal cord paralysis was lower for EBUS (1.4% versus 2.2%, p
Source: Chest - Category: Respiratory Medicine Authors: Tags: Chest Source Type: research

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Source: Thoracic Cancer - Category: Cancer & Oncology Authors: Tags: ORIGINAL ARTICLE Source Type: research
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Conclusion For small pulmonary nodules requiring thoracoscopic surgery, the optimized computed tomography-guided pulmonary nodule microcoil localization technique is convenient, safe and effective, and worthy of promotion to use. 
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