Abstract
Purpose: Although endobronchial ultrasonography with a guide sheath is becoming a common procedure for the diagnosis of peripheral pulmonary lesions, there remain to be some inaccuracies in cases wherein the probe is located outside the lesion. We tested whether adding transbronchial needle aspiration through a guide sheath to the conventional technique increases efficacy for diagnosing peripheral pulmonary lesions.
Methods: We performed transbronchial needle aspiration through a guide sheath for 37 subjects with peripheral pulmonary lesions between September 2012 and April 2013. The devices used were as follows (all Olympus Ltd.): bronchoscope with wide working channel (1T-260 or LF-TP), guide sheath measured 2.2 mm in diameter (K203 kit) and 13 mm length 21-G needle without side hole set through a metallic sheath (NA-1C-1)., The guide sheath was customized by cutting 30 mm from the proximal end to fit well with the needle.
Results: The endobronchial ultrasound probe was located within the lesion in 21 cases (56.8%) and outside in 16 cases (43.2%). Overall accuracy was 86.5 percent; 90.5% in “within” cases compared to 81.3% in “outside” cases with no significant difference (P = 0.42). Pneumothorax occurred in 2 cases and pneumonia in 1 case.
Conclusion: Transbronchial needle aspiration through a guide sheath is an effective and safe diagnostic procedure for peripheral pulmonary lesions, especially when the guide sheath is outside the lesion.
- © 2014 ERS
