# Role of General Anesthesia and Rapid On-site Evaluation in the Diagnosis of Lung Cancer with EBUS-TBNA

## TL;DR

This study examines whether general anesthesia and rapid on-site evaluation improve the accuracy of diagnosing lung cancer using EBUS-TBNA.

## Contribution

The study evaluates the impact of general anesthesia and ROSE on EBUS-TBNA outcomes for lung cancer diagnosis.

## Key findings

- General anesthesia with or without ROSE achieved similar diagnostic accuracy compared to local anesthesia.
- Combining general anesthesia with ROSE reduced the number of lymph node punctures needed.
- No serious complications or anesthesia-related adverse reactions were observed in any group.

## Abstract

背景与目的 肺癌是常见的呼吸系统恶性肿瘤。超声引导下经支气管针吸活检（endobronchial ultrasound-guided transbronchial needle aspiration, EBUS-TBNA）是诊断肺癌和评估分期的重要工具。EBUS-TBNA大多在局部麻醉或清醒镇静下进行，而在全身麻醉下行EBUS-TBNA以及同时应用快速现场评价（rapid on-site evaluation, ROSE）能否进一步提高诊断效能目前仍未可知，本研究拟探索全身麻醉及ROSE在EBUS-TBNA诊断肺癌中的价值。方法 回顾性分析164例于2018年1月至2022年12月于西南医科大学附属医院呼吸与危重医学科就诊患者的资料，所有患者术前均疑诊为肺癌并行EBUS-TBNA，根据是否行全身麻醉及ROSE将患者分为局麻组（n=54）、全麻组（n=67）和全麻ROSE组（n=43），分析各组的穿刺情况以及在疾病诊断方面的差异。结果 局麻组的淋巴结穿刺针数高于全麻ROSE组（P<0.01）。三组患者的疾病总诊断率分别为87.04%、89.55%和90.70%，恶性肿瘤的诊断率分别为88.24%、88.89%和94.74%，均无统计学差异（P>0.05）。三组中没有患者出现严重并发症及麻醉相关不良反应。结论 与局部麻醉联合静脉镇痛镇静相比，全身麻醉下实施EBUS-TBNA无论是否联合ROSE均可得到同样准确的结果，全身麻醉联合ROSE可以减少淋巴结穿刺针数。

General conditions and puncture conditions of the three groups

Distribution of puncture in the three groups

Diagnosis of the three groups