Comparison of diagnostic yield of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) using 15 versus 20 versus 25 lymph node agitations in patients with mediastinal lymphadenopathy: a randomized trial.

<bold>Introduction:</bold> Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a minimally invasive tool in the diagnosis and staging of lung cancer and other causes of mediastinal lymphadenopathy. The diagnostic yield of EBUS-TBNA varies widely, influenced by technical aspects of the procedure. This study investigates the optimal number of lymph node agitations to maximize diagnostic yield. <bold>Aims & Objectives:</bold> This study aims to compare the diagnostic yield of EBUS-TBNA using 15 versus 20 versus 25 lymph node agitations in patients with mediastinal lymphadenopathy. <bold>Methods:</bold> In this prospective, randomized study, a total of 120 patients presenting with mediastinal lymphadenopathy will be equally distributed in a 1:1:1 ratio into three groups, subjected to 15, 20, or 25 lymph node agitations, respectively. <bold>Results:</bold> Preliminary results from our study, included 92 patients, predominantly male (51%) with mean age of 52.67+-14.85 years. The diagnostic yields from the three groups - 15, 20, and 25 lymph node agitations, showed no significant statistical difference (86.2%, 82.4%, and 82.8% respectively; p = 0.94). Complications were minimal, comprising one instance of hypoxia, two moderate bleeding events, and five events of mild bleeding, with no significant differences in complication rates among the groups. <bold>Conclusion:</bold> Our study demonstrates that there is no significant difference in the diagnostic yield of EBUS-TBNA for mediastinal lymphadenopathy between groups subjected to 15, 20, and 25 lymph node agitations.