Recent developments in advanced diagnostic bronchoscopy

Chandrika, Sharad; Yarmus, Lonny

doi:10.1183/16000617.0184-2019

Cited by 11 publications

(9 citation statements)

References 70 publications

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“…In the past decades, bronchoscopy has undergone a great development and extensive use, and the types of procedures have changed and become more complex and sophisticated [1] . Because of the noncontemporaneous nature of previous studies, it is necessary to reanalyze the incidence and type of complications.…”

Section: Discussionmentioning

confidence: 99%

Hemorrhage Risk of Patients Receiving Bronchoscope Examination or Treatment

Bo¹,

Li²,

Jin³

et al. 2020

Preprint

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Background: The type of procedures has changed and become more complex and sophisticated with the development and extensive use of bronchoscopy. This study aimed to evaluate the safety, particularly the hemorrhage risk, of patients receiving bronchoscope examination or treatment.Methods: The general information and bronchoscope procedures of patients who underwent bronchoscope examination or treatment in the respiration department were collected and analyzed.Results: The incidence of complications and the mortality in bronchoscopy were 0.85% and 0.01%, respectively. The complication rate of different types of bronchoscope procedure varies significantly, and that of therapeutic bronchoscopies was higher than that of explorative examinations and biopsies. Moreover, the most common complication was severe bleeding. Bleeding rate was higher in the left upper lobe and bronchus intermedius, and a trend was observed in which the proportion of bleeding cases decreased as the number of biopsies increased.Conclusions: Although bronchoscope procedure has become more complex and sophisticated, bronchoscopy is well tolerated. However, precautions should be taken because the risks of hemorrhage and pneumothorax were high and fatal.

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Section: Discussionmentioning

confidence: 99%

Hemorrhage Risk of Patients Receiving Bronchoscope Examination or Treatment

Bo¹,

Li²,

Jin³

et al. 2020

Preprint

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“…Several studies have reported complication rates up to 1.44% [ 30 – 34 ]. Substantial evidence also suggests that CEBUS-TBNA exhibits high diagnostic yield and low complication rates in diagnosing benign diseases [ 35 , 36 ]. These CEBUS-TBNA findings align with the diagnostic yield of 92% and complication rate of 4% reported herein.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic efficacy and safety of radial probe endobronchial ultrasound-guided transbronchial needle aspiration for adjacent lesions in segmental or subsegmental bronchi: a single-center retrospective study

Ma,

Zhang,

Zeng

et al. 2023

BMC Pulm Med

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Background Peripheral lung lesions can be sampled using various techniques, including computer tomography-guided transthoracic needle aspiration, electromagnetic navigation bronchoscopy, virtual navigation bronchoscopy, and radial probe endobronchial ultrasound transbronchial lung biopsy. Mediastinal lesions can be sampled using techniques like convex probe endobronchial ultrasound-guided transbronchial needle aspiration (CEBUS-TBNA) and endoscopic ultrasound-fine-needle aspiration. However, effective, safe techniques for lesions adjacent to the segmental or subsegmental bronchi are lacking. Herein, we retrospectively evaluated the diagnostic yield and safety of radial probe endobronchial ultrasound-assisted transbronchial needle aspiration (REBUS-TBNA) for lesions adjacent to the segmental bronchi, and explored the factors related to diagnostic yield. Methods We retrospectively analyzed the diagnostic yield and safety of REBUS-TBNA cases performed in our department from January 2019 to December 2022. Observation group patients had undergone REBUS-TBNA for lesions adjacent to the segmental bronchi; control group patients had undergone CEBUS-TBNA for mediastinal or hilar lesions. Patient characteristics and lesion sizes, diagnostic yield, adverse events, and relations between diagnostic yield and clinical characteristics were analyzed. Results There were not statistically significant between-group differences in sex, age, diagnostic yield, or rate of adverse events. The observation group (n = 25; 17 male, 8 female) had a mean age of 64.76 ± 10.75 years. The average lesion size was 4.66 ± 1.07 cm, and lesions were predominantly in the upper lobes (80%). REBUS-TBNA diagnostic yield was 84%, with no adverse events reported. Diagnostic yield was not associated with lesion size or extent of bronchial stenosis; however, it was positively correlated with number of punctures. Patients with > 3 punctures had a significantly higher diagnostic yield than those with ≤ 3 punctures. Conclusions REBUS-TBNA is a safe, effective diagnostic technique, particularly for lesions adjacent to the segmental or subsegmental bronchi of the upper lobe. Performing more than three punctures during the procedure improves the diagnostic yield. Larger-scale studies are warranted to confirm these results, and to further explore the clinical value of REBUS-TBNA.

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“…Importantly, in addition to obtaining diagnostic tissue specimens using biopsy forceps, bronchoscopy with brushing or bronchoalveolar lavage can also contribute to the diagnosis with remarkable specificity 150 . Among the newer bronchoscopy‐based technologies, 151 endobronchial ultrasound‐guided transbronchial needle aspiration is preferably used for tumors with peribronchial localization and for enlarged mediastinal or hilar lymph nodes 146,152 . Another approach for mediastinal staging is mediastinoscopy (Figure 5B), which is performed under general anesthesia.…”

Section: Diagnosis Screening and Preventionmentioning

confidence: 99%

Clinical insights into small cell lung cancer: Tumor heterogeneity, diagnosis, therapy, and future directions

Gay

Popper

Pirker

et al. 2023

CA A Cancer J Clinicians

108

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Small cell lung cancer (SCLC) is characterized by rapid growth and high metastatic capacity. It has strong epidemiologic and biologic links to tobacco carcinogens. Although the majority of SCLCs exhibit neuroendocrine features, an important subset of tumors lacks these properties. Genomic profiling of SCLC reveals genetic instability, almost universal inactivation of the tumor suppressor genes TP53 and RB1, and a high mutation burden. Because of early metastasis, only a small fraction of patients are amenable to curative‐intent lung resection, and these individuals require adjuvant platinum‐etoposide chemotherapy. Therefore, the vast majority of patients are currently being treated with chemoradiation with or without immunotherapy. In patients with disease confined to the chest, standard therapy includes thoracic radiotherapy and concurrent platinum‐etoposide chemotherapy. Patients with metastatic (extensive‐stage) disease are treated with a combination of platinum‐etoposide chemotherapy plus immunotherapy with an anti‐programmed death‐ligand 1 monoclonal antibody. Although SCLC is initially very responsive to platinum‐based chemotherapy, these responses are transient because of the development of drug resistance. In recent years, the authors have witnessed an accelerating pace of biologic insights into the disease, leading to the redefinition of the SCLC classification scheme. This emerging knowledge of SCLC molecular subtypes has the potential to define unique therapeutic vulnerabilities. Synthesizing these new discoveries with the current knowledge of SCLC biology and clinical management may lead to unprecedented advances in SCLC patient care. Here, the authors present an overview of multimodal clinical approaches in SCLC, with a special focus on illuminating how recent advancements in SCLC research could accelerate clinical development.

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Recent developments in advanced diagnostic bronchoscopy

Cited by 11 publications

References 70 publications

Hemorrhage Risk of Patients Receiving Bronchoscope Examination or Treatment

Hemorrhage Risk of Patients Receiving Bronchoscope Examination or Treatment

Diagnostic efficacy and safety of radial probe endobronchial ultrasound-guided transbronchial needle aspiration for adjacent lesions in segmental or subsegmental bronchi: a single-center retrospective study

Clinical insights into small cell lung cancer: Tumor heterogeneity, diagnosis, therapy, and future directions

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