Endobronchial ultrasonography using a guide sheath technique for diagnosis of peripheral pulmonary lesions

Zhang, Lei; Wu, Hongxu; Wang, Guiqi

doi:10.4103/eus.eus_48_17

Cited by 23 publications

(20 citation statements)

References 46 publications

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“…The literature reported that the total complication rate was 0−6.7%. The most common complication is pneumothorax, with an incidence of 0−7.5%, only 0.6% of patients need chest tube drainage, and the incidence of infection is about 0.5% ( 6 , 17 , 24 , 25 ). No patients with massive bleeding or operation-related deaths have been reported.…”

Section: Discussionmentioning

confidence: 99%

“…Early diagnosis of these lesions is of great importance to reduce mortality owing to lung cancer ( 5 ). In recent years, endobronchial ultrasonography with guide sheath (EBUS-GS) has produced favorable results in the diagnosis of PPLs ( 6 ). However, EBUS-GS is only designed to confirm arrival at the lesion, fluoroscopy is still needed for guidance before the confirmation ( 7 ).…”

Section: Introductionmentioning

confidence: 99%

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Virtual bronchoscopic navigation without fluoroscopy guidance for peripheral pulmonary lesions in inexperienced pulmonologist

Yan

Chen

et al. 2020

Chinese Journal of Cancer Research

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Objective Fluoroscopy guidance is generally required for endobronchial ultrasonography with guide sheath (EBUS-GS) in peripheral pulmonary lesions (PPLs). Virtual bronchoscopic navigation (VBN) can guide the bronchoscope by creating virtual images of the bronchial route to the lesion. The diagnostic yield and safety profiles of VBN without fluoroscopy for PPLs have not been evaluated in inexperienced pulmonologist performing EBUS-GS. Methods Between January 2016 and June 2017, consecutive patients with PPLs referred for EBUS-GS at a single cancer center were enrolled. The diagnostic yield as well as safety profiles was retrospectively analyzed, and our preliminary experience was shared. Results A total of 109 patients with 109 lesions were included, 99 (90.8%) lesions were visible on EBUS imaging. According to the procedure time needed to locate the lesion on EBUS, 24.8% (27/109) were deemed technically difficult procedures; however, no significant relationships were identified between candidate parameters and technically difficult procedures. The overall diagnosis yield was 74.3% (81/109), and the diagnostic yield of malignancy was 83.7% (77/92). Lesions larger than 20 mm [odds ratio (OR), 2.758; 95% confidence interval (95% CI), 1.077−7.062; P=0.034] and probe of within type (OR, 3.174; 95% CI, 1.151−8.757, P=0.026) were independent factors leading to a better diagnostic yield in multivariate analysis. About 30 practice procedures were needed to achieve a stable diagnostic yield, and the proportion of technically difficult procedures decreased and stabilized after 70 practice procedures. Regarding complications, one patient (0.9%) had intraoperative hemorrhage (100 mL) which was managed under endoscopy. Conclusions VBN without fluoroscopy guidance is still useful and safe for PPLs diagnosis, especially for malignant diseases when performed by pulmonologist without previous experience of EBUS-GS. VBN may simplify the process of lesion positioning and further multi-center randomized studies are warranted.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Virtual bronchoscopic navigation without fluoroscopy guidance for peripheral pulmonary lesions in inexperienced pulmonologist

Yan

Chen

et al. 2020

Chinese Journal of Cancer Research

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“…The diagnostic yield of radial miniprobe is 60-70% when it used alone and increased until 84% with fluoroscopic guide and when was used in combination with virtual bronchoscopic navigation the overall diagnostic yield increased to 63.3-84%. 11,17 side the lesion (Figure 2, 3, 4). Bronchus sign is associated with the diagnostic sensitivity of miniprobe.…”

Section: Fluoroscopy Guidancementioning

confidence: 96%

Competence in navigation and guided transbronchial biopsy for peripheral pulmonary lesions

Livi

Barisione

Zuccatosta³

et al. 2019

Panminerva Med

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A B S T R A C TOptions for non-surgical tissue diagnosis of the peripheral nodule include CT scan-guided TTNA, fluoroscopy-guided bronchoscopy, radial endobronchial ultrasound (EBUS), electromagnetic navigation bronchoscopy (ENB), and virtual bronchoscopy navigation (VBN). For physicians who choose to pursue non-surgical biopsy, the decision to perform CT scan-guided or ultrasound-guided TTNA, conventional bronchoscopy or bronchoscopy guided by EBUS, ENB, or VBN will depend on a number of factors. CT scan-guided TTNA is preferable for nodules located near the chest wall or for deeper lesions, provided that there is no need to go through the fissures and there is no surrounding emphysema. Ultrasound-guided TTNA requires contact between the lesion and the costal pleura. Bronchoscopic techniques are preferable for nodules ≥2 cm located near a patent bronchus, or in individuals at high risk for pneumothorax following TTNA. In most other situations, operator experience should guide the decision. Trainees must possess a perfect knowledge of anatomy and be fully competent in the interpretation of imaging (CT with contrast medium and PET) and have a thorough knowledge of navigation technology in all its complexities. Practical training can be performed on animal, cadaver or plastic models. In the last years, to improve diagnostic yield, navigational bronchoscopy has attracted significant attention.

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“…The complication rates were lower (0% to 7.4%) than CT-guided TTNB [ 56 - 58 ]. Pneumothorax occurred in 1.0% of the patients [ 59 ], and bleeding, infection, and breaking of radial probes can occur in some cases [ 58 ].…”

Section: Endobronchial Ultrasound and A Guide Sheathmentioning

confidence: 99%

An update on the role of bronchoscopy in the diagnosis of pulmonary disease

Ahn

2020

Yeungnam Univ J Med

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Bronchoscopy has evolved over the past few decades and has been used by respiratory physicians to diagnose various airway and lung diseases. With the popularization of medical check-ups and growing interest in health, early diagnosis of lung diseases is essential. With the development of endobronchial ultrasound, ultrathin bronchoscopy, and electromagnetic navigational bronchoscopy, bronchoscopy has been able to widen its scope in diagnosing pulmonary diseases. In this review, we have described the brief history, role, and complications of bronchoscopy used in diagnosing pulmonary lesions, from simple flexible bronchoscopy to bronchoscopy combined with several up-to-date technologies.

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Endobronchial ultrasonography using a guide sheath technique for diagnosis of peripheral pulmonary lesions

Cited by 23 publications

References 46 publications

Virtual bronchoscopic navigation without fluoroscopy guidance for peripheral pulmonary lesions in inexperienced pulmonologist

Virtual bronchoscopic navigation without fluoroscopy guidance for peripheral pulmonary lesions in inexperienced pulmonologist

Competence in navigation and guided transbronchial biopsy for peripheral pulmonary lesions

An update on the role of bronchoscopy in the diagnosis of pulmonary disease

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