Abstract
Background
Although the diagnostic yield of guided bronchoscopy for peripheral pulmonary lesions (PPLs) has improved to 70%, it is still low compared to transthoracic needle aspiration. We produced a new bronchoscope with middle-range diameter and large channel (BF-Y0053, Olympus, Japan), and evaluated its diagnostic efficacy for PPLs.
Patients and Methods
This was a retrospective study on 70 consecutive patients with PPLs who underwent diagnostic bronchoscopy using BF-Y0053 combined with endobronchial ultrasound with a guide sheath (EBUS-GS) at the National Cancer Center, Tokyo, Japan, from September 2013 to November 2013. Diagnostic performance of the procedure was analyzed and compared among 3 groups of PPLs: “peripheral-small” lesions (≤30mm and adjacent to visceral pleura), “central-small” lesions (≤30mm and not adjacent to the visceral pleura), and “large” lesions (>30mm).
Results
Diagnosis was established by bronchoscopy in 61 of 70 patients (87.1%); the respective yields for “central-small” and “large” lesions were significantly higher than that for “peripheral-small” lesions (96.3%, 94.4%, 72%, p=0.0026). This diagnostic accuracy was achieved regardless of other clinical and procedural factors such as, lesion size, feature (GGO or solid), EBUS-probe location (within or outside), or operator skill. There were no major post-procedural complications.
Conclusions
BF-Y0053 combined with EBUS-GS can enhance the efficacy of transbronchial sampling to its maximal potential to diagnose PPLs safely and accurately, particularly for patients who have tumors away from the visceral pleura.
- © 2014 ERS
