Results
The initial search yielded 238 study results. No previously published
systematic review or meta-analysis on the subject was found. After
initial screening, 14 eligible articles on EBUS-TBNA/EUS-B-FNA in
children were identified. Twelve studies (including 173 patients)
described the utilization of EBUS-TBNA or EUS-B-FNA in pediatric
mediastinal lymphadenopathy. Two articles were excluded as one described
utilization of EUS-B-FNA for intra-abdominal pathology, and one case
report described the use of EBUS for airway wall involvement assessment
in a patient with mucoepidermoid carcinoma. (8, 9) Of the finally
selected 12 articles, five were case series that included greater than
five patients, and seven were single patient case reports (except one
article that described EBUS-TBNA in two children)(10). The abstracted
data of the five major case series are summarized in Table 1. These five
case series (including 164 children) were included in the meta-analysis
for calculation of the pooled summary statistics for diagnostic yield
and sampling adequacy. (11-15) In all, a total of 173 patients underwent
EBUS-TBNA/EUS-B-FNA.
The five major case series included 164 patients (90 males, 54.9%). All
the studies were retrospective in nature. Four out of the five were
multicentric (except Gulla KM et al., India).(13) Two studies reported
the use of only EBUS-TBNA(11, 15), two used both EBUS-TBNA and
EUS-B-FNA(13, 14), while one study used Radial EBUS along with
EBUS-TBNA.(12) For the study where both EBUS-TBNA and Radial EBUS were
used, data is summarized for only the patients who underwent EBUS-TBNA.
General anaesthesia (GA) was used in one study(12), three studies used
both GA and moderate sedation(11, 14, 15), while in one study(13),
procedures were performed only using moderate sedation. The most common
EBUS bronchoscope used was the Olympus BF-UC-180F (6.9 mm outer diameter
with a 2.2 mm working channel). 21G (13, 14) and 22G needle (11, 12) was
used in two studies each. A total of 238 nodes were sampled. The most
frequently sampled lymph node stations were Subcarinal (Station 7) and
lower right paratracheal (Station 4R). Rapid On-Site Evaluation (ROSE)
was performed in three of the five studies.(11, 12, 15) The mean
procedure duration was 20 min (Range 18-30 min).(14)