Endobronchial ultrasound-guided transbronchial needle aspiration - INAHTA Brief

The objective is to assess endobronchial ultrasound-guided transbronchial needle aspiration or EBUS-TBNA for exploring the mediastinal lymph nodes in the following indications:

• for malignant diseases:
  • lymph node staging (or assessment of lymph node status) in lung cancer, primarily non-small cell lung cancer (NSCLC): in the case of inoperable NSCLC, preoperative assessment of mediastinal spread (staging) is essential for identifying N2 and particularly N3 lymphadenopathy which contraindicates surgical treatment;
  • diagnosis of NSCLC;
  • restaging of NSCLC, particularly management of stage IIIa N2 NSCLC;
  • diagnosis of small-cell lung cancer (SCLC);
  • diagnosis of lymphoma;
  • exploration of mediastinal or hilar lymph nodes in the context of an extrathoracic cancer;
  • exploration of pulmonary masses in contact with the tracheobronchial wall;
• for benign diseases:
  • diagnosis of granulomatosis, sarcoidosis or tuberculosis;
  • Exploration of any mediastinal lymph nodes

The aim is to include EBUS-TBNA on the list of procedures refundable by National Health Insurance, bearing in mind that there are alternative and/or complementary procedures already listed which cover part of the procedure, namely conventional transbronchial needle aspiration, endoscopic ultrasound-guided fine needle aspiration (EUS-FNA), and other more invasive techniques such as mediastinal exploration via mediastinoscopy (currently considered the standard technique for mediastinal assessment), thoracoscopy or thoracotomy