Toshiyuki Sumi1, Takumi Ikeda2, Takeyuki Sawai3, Naoki Shijubou3, Kenichi Kure4, Yuichi Yamada5, Hisashi Nakata5, Yuji Mori5, Hiroki Takahashi6. 1. Department of Pulmonary Medicine, Hakodate Goryoukaku Hospital, Japan; Department of Respiratory Medicine and Allergology, Sapporo Medical University School of Medicine, Japan. Electronic address: tsh715@gmail.com. 2. Department of Pulmonary Medicine, Kushiro General Hospital, Japan; Department of Respiratory Medicine and Allergology, Sapporo Medical University School of Medicine, Japan. 3. Department of Pulmonary Medicine, Hakodate Goryoukaku Hospital, Japan; Department of Respiratory Medicine and Allergology, Sapporo Medical University School of Medicine, Japan. 4. Department of Pulmonary Medicine, Shihoro General Hospital, Japan; Department of Respiratory Medicine and Allergology, Sapporo Medical University School of Medicine, Japan. 5. Department of Pulmonary Medicine, Hakodate Goryoukaku Hospital, Japan. 6. Department of Respiratory Medicine and Allergology, Sapporo Medical University School of Medicine, Japan.
Abstract
BACKGROUND: For the precise management of advanced lung cancers, bronchoscopy with a high diagnostic yield and abundant tumor specimens are required. In recent years, new devices and techniques have been rapidly developed, including the endobronchial ultrasound (EBUS) using a guide sheath, virtual bronchoscopic navigation (VBN), and ultra-thin bronchoscope (UTB), for the diagnosis of peripheral pulmonary lesions (PPLs). These techniques increase the diagnostic yield for PPL, thus requiring fewer biopsy specimens. VBN is generally not available at the city hospitals in Japan. In this study, using fluoroscopy without VBN, we studied whether the histologic diagnostic yield of radial EBUS for PPLs would be higher using a UTB (without guide sheath) or conventional bronchoscope (CB) (with guide sheath). METHODS: We retrospectively reviewed consecutive patients with suspected lung cancer who underwent bronchoscopy at the Hakodate Goryoukaku Hospital from April 2017 to March 2019. We analyzed 168 patients-102 using UTB and 66 using CB. RESULTS: The diagnostic yields for PPL were significantly higher in the UTB group than in the CB group (74.5% vs. 59.1%; P = 0.04). The median examination time was significantly longer in the UTB group than in the CB group (24 vs. 20 min; P = 0.01). There were no statistically significant differences in the complication rate between the UTB and CB groups (3.9% vs. 3.0%; P = 0.69). CONCLUSIONS: UTB had a significantly higher tissue diagnostic yield than CB, without the use of VBN.
BACKGROUND: For the precise management of advanced lung cancers, bronchoscopy with a high diagnostic yield and abundant tumor specimens are required. In recent years, new devices and techniques have been rapidly developed, including the endobronchial ultrasound (EBUS) using a guide sheath, virtual bronchoscopic navigation (VBN), and ultra-thin bronchoscope (UTB), for the diagnosis of peripheral pulmonary lesions (PPLs). These techniques increase the diagnostic yield for PPL, thus requiring fewer biopsy specimens. VBN is generally not available at the city hospitals in Japan. In this study, using fluoroscopy without VBN, we studied whether the histologic diagnostic yield of radial EBUS for PPLs would be higher using a UTB (without guide sheath) or conventional bronchoscope (CB) (with guide sheath). METHODS: We retrospectively reviewed consecutive patients with suspected lung cancer who underwent bronchoscopy at the Hakodate Goryoukaku Hospital from April 2017 to March 2019. We analyzed 168 patients-102 using UTB and 66 using CB. RESULTS: The diagnostic yields for PPL were significantly higher in the UTB group than in the CB group (74.5% vs. 59.1%; P = 0.04). The median examination time was significantly longer in the UTB group than in the CB group (24 vs. 20 min; P = 0.01). There were no statistically significant differences in the complication rate between the UTB and CB groups (3.9% vs. 3.0%; P = 0.69). CONCLUSIONS:UTB had a significantly higher tissue diagnostic yield than CB, without the use of VBN.