Abstract
Background Guide sheaths (GSs) have been widely used during radial probe endobronchial ultrasound-guided transbronchial biopsy (rEBUS-TBB) of peripheral pulmonary lesions. However, it remains unknown whether a GS enhances the diagnostic yield. We compared the diagnostic yields of small peripheral pulmonary lesions between rEBUS-TBB with and without a GS.
Methods In eight institutions, patients with peripheral pulmonary lesions ≤30 mm in diameter were enrolled and randomised to undergo rEBUS-TBB with a GS (GS group) or without a GS (non-GS group) using a 4.0-mm thin bronchoscope, virtual bronchoscopic navigation and fluoroscopy. The primary end-point was the diagnostic yield of the histology specimens.
Results A total of 605 patients were enrolled; ultimately, data on 596 (300 in the GS group and 296 in the non-GS group) with peripheral pulmonary lesions having a longest median diameter of 19.6 mm were analysed. The diagnostic yield of histological specimens from the GS group was significantly higher than that from the non-GS group (55.3% versus 46.6%; p=0.033). Interactions were evident between the diagnostic yields, procedures, lobar locations (upper lobe versus other regions; p=0.003) and lesion texture (solid versus part-solid nodules; p=0.072).
Conclusions The diagnostic yield for small peripheral pulmonary lesions afforded by rEBUS-TBB using a GS was higher than that without a GS.
Abstract
Use of a guide sheath during endobronchial ultrasound-guided transbronchial biopsy enhances the diagnostic yield for small peripheral pulmonary lesions https://bit.ly/3utOUHk
Footnotes
This article has supplementary material available from erj.ersjournals.com
This study is registered at the University Hospital Medical Information Network-Clinical Trials Registry with identifier UMIN000024305. Individual participant data that underlie the results reported in this article, after de-identification (text, tables, figures and appendices), and the study protocol will be made available beginning 9 months and ending 36 months after article publication, to investigators whose proposed use of the data has been approved by an independent review committee (“learned intermediary”) identified for this purpose, for individual participant data meta-analysis. Proposals may be submitted up to 36 months following article publication and should be directed to the corresponding author. To gain access, data requestors will need to sign a data access agreement.
Conflict of interest: M. Oki reports speaker fees from Olympus Corporation as an invited guest speaker at academic medical meetings. All other authors have nothing to disclose.
Support statement: This study was supported by a grant from the Japanese Foundation for Research and Promotion of Endoscopy. Two virtual bronchoscopic navigation systems were loaned to the authors by Olympus (Tokyo, Japan). Funding information for this article has been deposited with the Crossref Funder Registry.
- Received June 14, 2021.
- Accepted September 27, 2021.
- Copyright ©The authors 2022. For reproduction rights and permissions contact permissions{at}ersnet.org
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