Continuing practice is needed to maintain competency in endobronchial ultrasound‑guided transbronchial needle aspiration

Background: It has been accepted that after training, a competent EBUS operator should perform at least twenty procedures per year. However, the literature supporting this subject is scarce. This study focuses on the return performance of an experience bronchoscopist after a five-year-long brake. The aim is to reveal a possible decrease in the diagnostic performance after discontinued practice.
Methods: The data of patients who have undergone EBUS-TBNA for mediastinal or hilar lesions (lymphadenopathies and masses) between April-September 2016 were reviewed retrospectively. All consecutive patients were involved in the study. All EBUS-TBNA procedures were performed by a single experienced bronchoscopist who have returned after a five-year-long brake and re-started to perform EBUS. The patients were divided into two groups: first twenty-cases and subsequent eighty cases. The diagnostic performance of EBUS was compared between two groups.
Results: One hundred consecutive patients were included (2.89 lesions per patient). Demographic and sonographic data were not different between two groups. In overall, EBUS-TBNA was diagnostic in 281 of 289 lesions (97.2%). The sensitivity of EBUS-TBNA in first and second groups were 92.9% and 98.3%, respectively. The difference was statistically significant (p=0.048).
Conclusion: This study shows the need for continuing practice in EBUS. An operator should perform at least twenty procedures per year to maintain competency.