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Updated: Jan 26, 2026
Substernal Thyroid Biopsy Using Endobronchial Ultrasound-guided Transbronchial Needle Aspiration
Published on: November 10, 2014
LMA® Protector™ versus traditional LMA to perform endobronchial ultrasound-guided transbronchial needle aspiration: a
Enzo Zamparelli1, Alfonso Fiorelli2, Giuseppe La Cerra3
1Unit of Anesthesiology and Intensive Care, Vincenzo Monaldi Hospital, Naples, Italy - enzozamparelli@gmail.com.
Background:
The aim of this study was to evaluate the use of laryngeal mask airway (LMA)® Protector™ by comparison with traditional LMA for performing endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA).
Methods:
This was a retrospective observational single-center study including 143 patients who underwent EBUS-TBNA for mediastinal staging of lung cancer. Patients were retrospectively divided into two groups based on whether a traditional LMA (traditional LMA group) or LMA Protector was used. Anesthesiologist outcomes, diagnostic yield of EBUS-TBNA, and complications related to the procedure were computed for each group and statistically compared.
Results:
LMA traditional group and LMA Protector group counted 70 and 73 patients, respectively. LMA traditional group versus LMA Protector group showed no significant difference on time of LMA insertion (120±25 vs. 118±39 s; P=0.49), reposition rates (18% vs. 16%; P=0.78); systolic pressure (140±55 vs. 118±37 mmHg; P=0.59); diastolic pressure (82±15 vs. 90±26 mmHg; P=0.39); heart rate (82±9.9 vs. 83±20 bpm; P=0.49); SpO2 values (93±21% vs. 92±14%; P=0.63); diagnostic accuracy (91.3% vs. 92%; P=0.95), and patients' complications as nausea (4% vs. 3%; P=0.61); vomiting (3% vs. 1%, P=0.96); gastric aspiration (7% vs. 1%; P=0.08); and sore throat (7% vs. 3%; P=0.22). Conversely, LMA traditional group versus LMA Protector group presented a longer procedural time (47±23 vs. 38±17 s; P=0.02), higher number of passage to biopsy target lesion (4±0.5 vs. 3.1±0.6; P=0.01); higher rate of balloon ultrasound rupture (11% vs. 1%; P=0.01).
Conclusions:
EBUS-TBNA conducted with LMA Protector is a useful strategy that reduced the procedural time and in theory ensured the comfort of patients. Our results should be confirmed by larger, prospective, randomized studies.
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