Objective:To compare the satisfaction and tolerability of patients under local anesthesia with conscious sedation and simple local anesthesia in Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration (EBUS-TBNA) .Methods :Sixty patients undergoing EBUS-TBNA operation were randomly divided into local anesthesia with conscious sedation group (Group A) and simple local anesthesia group (Group B) ,with 30 patients in each group .The satisfaction and tolerability of patients , safety and accuracy of operations were observed by preoperative records ,intraoperative observation ,postoperative question-naires and follow-up .Results :Compared with Group B ,the blood oxygen saturations of patients before ,during and after oper-ation in Group A decreased significantly (P<0 .05) .The mean contractive pressure of patients before and during operation in Group A were significantly lower than that in Group B .However ,there were no significant differences in the satisfaction and tolerability ,the incidence rates of complications of patients and diagnostic accuracy in two groups .Conclusions :The simple lo-cal anesthesia in EBUS-TBNA in Outpatient Department is safe and effective ,with good satisfaction and tolerability .

Background and objective Endobronchial ultrasound guided transbronchial needle aspiration (EBUS-TBNA) has been widely applied in diagnosing mediastinal and hilar adenopathy. hTis study is further to evaluate value and safety of EBUS-TBNA in diagnosing intrathoracic metastasis from extrapulmonary malignancy. Methods Prospectively analysis of 41 patients suspected intrathoracic metastasis from previous diagnosed/concurrent extrapulmonary malignancies in Shanghai Chest Hospital, with radiologic ifndings showing mediastinal/hilar lymph node enlargement or intrapulmonary lesion requiring EBUS-TBNA examination for pathological diagnosis. Results 41 candidate patients enrolled, and 67 mediastinal/hilar lymph nodes and 5 intrapulmonary lesions were aspirated. 14 intrathoracic metastasis, 10 primary lung cancer, 9 reactive lymphadenitis, 4 sarcoid-like reactions, and 1 tuberculosis was diagnosed by EBUS-TBNA. Sensitivity and accuracy of EBUS-TBNA in diagnosing intra-thoracic metastasis was 87.50%and 95.12%, respectively. Immunohistochemistry (IHC) was performed in 18 malignant tumors to obtain deifnite type or origin, twelve intrathoracic metastasis and 6 primary lung cancer were further conifrmed. Conclusion EBUS-TBNA is a safe, effective method for the diagnosis of intrathoracic metastasis from extrapulmonary malignancy. IHC can provide additional evidence for distinguishing extrapulmonary malignancy from primary lung cancer.