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Indications des ponctions par voie transbronchique

Indications of transbronchial needle aspiration

  • Published:
Acta Endoscopica

Résumé

Les ponctions par voie transbronchique se sont considérablement développées avec l’avènement de l’échographie endobronchique qui permet de mieux guider les prélèvements. La démarche diagnostique des nodules ou des lésions pulmonaires périphériques soulève toujours des controverses. Dans cette indication, l’échographie endobronchique combinée à la ponction transbronchique (ou à d’autres techniques de prélèvement), a un rendement diagnostique supérieur à la bronchoscopie souple traditionnelle, indépendamment de la taille de la lésion; de plus, cette technique est sûre. L’évaluation tissulaire des ganglions médiastinaux est souvent requise dans le staging du cancer bronchoplumonaire et l’échographie endobronchique donne d’excellents résultats et est complémentaire de l’échographie œsophagienne. Elle est d’un apport diagnostique intéressant dans d’autres atteintes malignes ou bénignes (sarcoïdose) des ganglions médiastinaux ou hilaires. Cette technique devrait diminuer le recours aux explorations médiastinales chirurgicales.

Summary

Transbronchial needle aspiration use has considerably increased with the development of endobronchial ultrasound (EBUS). The diagnostic work-up of peripheral lung lesions or nodules remains controversial. In this indication, EBUS with guided sampling have increased the yield of conventional flexible bronchoscopy and results seem to be independent of lesion size.

Mediastinal lymph node tissue diagnosis is often required in the staging of lung cancer and real-time guided EBUS or EUS (endoscopic ultrasound, transoesophageal ultrasound) sampling show excellent results without significant complication. They may also allow reaching the diagnosis with a high sensitivity in other malignant or benign (sarcoidosis) diseases of mediastinal lymph nodes. The combination of EBUS and EUS may also be complementary and may then allow complete staging of the mediastinum that will probably reduce the need for surgical staging.

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Author notes

  1. V. Ninane

    Present address: Service de Pneumologie, Hôpital Saint-Pierre, Rue Haute 322, 1000, Bruxelles, Belgique

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    Ninane, V. Indications des ponctions par voie transbronchique. Acta Endosc 38, 31–36 (2008). https://doi.org/10.1007/BF02961971

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    • DOI: https://doi.org/10.1007/BF02961971

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