Evolution of Indications for Transbronchial Ganglionic Ultrasound
Evolution of Indications for Transbronchial Ganglionic Ultrasound
New indications for bronchial echo-endoscopies with transbronchial needle aspiration
 (EBUS-PTBA) have appeared since the first French centers with this technique were fitted.
 Evaluate the respective share of each indication of EBUS-AWPB over time over the period 2008
 - 2013
Transbronchial puncture is a technique known for many years with the first description found
 in 1949 by Shieppati. Subsequently, this technique allowing an exploration of the mediastinal
 lymph nodes became widespread with the work of Wang in 1983. However, the need to have exact
 knowledge of the different puncture sites in order to obtain maximum profitability with this
 examination in particular In staging and diagnosis in bronchopulmonary cancers (CBP) explains
 a significant difference in profitability between operators based on their experience. It was
 not until 1990 that Germans coupled the technique of radial ultrasound with that of
 bronchoscopy by introducing a balloon catheter inflated with a liquid allowing the best
 transmission of ultrasound. It is the German team of Herth who developed this technique in
 1999 under the name of bronchial echo-endoscopy (EBUS). The association of echo-endoscopy
 before transbronchial punctures significantly improves the performance of the examination. In
 2004, Yasufusu shows the interest of the real-time visualization of the lymph nodes for the
 marking as well as the punctures. Therefore, the indications for bronchial echoendoscopies
 with transbronchial needle puncture (EBUS-PTBA) are precisely defined in the nodal staging of
 CBP with good profitability and a reduction in surgical mediastinoscopy. Then, over time,
 there is an extension of indications with the diagnosis of Non-Small Cell Lung
 Broncho-Pulmonary Cancers (NSCLC) or Small Cell Broncho-Pulmonary Cancers (CBPC), the
 diagnosis of ganglion metastases of extra-thoracic primary tumors , Diagnosis of sarcoidosis
 or other more anecdotal uses (tuberculosis, lymphoma).

 Two Picard centers were among the first in France to be equipped with echoendoscopes (2007
 for the CH of Saint Quentin and 2008 for the CHU of Amiens). This allows our two centers to
 have a fairly consistent retreat on the technique since its implantation in France. While
 many studies are concerned with one or other indication in isolation, there is no study to
 the best of our knowledge relating the evolution over time of the respective share of each of
 these indications in daily practice . Given the current multiplication of potential
 indications for EBUS-PTBA, it seems interesting to analyze the place of these new indications
 in the daily activity of endoscopic centers equipped with an echo-endoscope. The main
 objective is to evaluate the respective share of each indication over time over the study
 period. Secondary objectives are the evaluation of the diagnostic performance of EBUS-PTBA,
 the evaluation of the abusively carried-out EBUS-PTBA (examination carried out for purely
 diagnostic purposes, whereas conventional bronchial fibroscopy Diagnosis of certainty) and
 evaluation of concordance between EBUS-PTBA and surgery in CBP staging indications.
Inclusion Criteria:

 -  Patients who underwent a first linear echo-endoscopy at the CHU of Amiens and the CH
 of Saint-Quentin between January 2008 and December 2013

 Exclusion Criteria:

 -  Patient sent by a center outside Picardie

 -  Patient having expressed a refusal to participate in the protocol