Cargando…

Use of Ultrathin Bronchoscope on a Need Basis Improves Diagnostic Yield of Difficult-to-Approach Pulmonary Lesions

There are cases of peripheral lung nodules that are difficult to approach despite using ancillary diagnostic devices during multimodal bronchoscopy. The use of ultrathin bronchoscopes has shown superiority over standard thin bronchoscopes. We retrospectively evaluated whether substitution of the thi...

Descripción completa

Detalles Bibliográficos
Autores principales: Nishii, Yoichi, Nakamura, Yuki, Fujiwara, Kentaro, Ito, Kentaro, Sakaguchi, Tadashi, Suzuki, Yuta, Furuhashi, Kazuki, Kobayashi, Tetsu, Yasuma, Taro, D'Alessandro-Gabazza, Corina N., Gabazza, Esteban C., Asano, Fumihiro, Taguchi, Osamu, Hataji, Osamu
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7771655/
https://www.ncbi.nlm.nih.gov/pubmed/33385003
http://dx.doi.org/10.3389/fmed.2020.588048
_version_ 1783629714290638848
author Nishii, Yoichi
Nakamura, Yuki
Fujiwara, Kentaro
Ito, Kentaro
Sakaguchi, Tadashi
Suzuki, Yuta
Furuhashi, Kazuki
Kobayashi, Tetsu
Yasuma, Taro
D'Alessandro-Gabazza, Corina N.
Gabazza, Esteban C.
Asano, Fumihiro
Taguchi, Osamu
Hataji, Osamu
author_facet Nishii, Yoichi
Nakamura, Yuki
Fujiwara, Kentaro
Ito, Kentaro
Sakaguchi, Tadashi
Suzuki, Yuta
Furuhashi, Kazuki
Kobayashi, Tetsu
Yasuma, Taro
D'Alessandro-Gabazza, Corina N.
Gabazza, Esteban C.
Asano, Fumihiro
Taguchi, Osamu
Hataji, Osamu
author_sort Nishii, Yoichi
collection PubMed
description There are cases of peripheral lung nodules that are difficult to approach despite using ancillary diagnostic devices during multimodal bronchoscopy. The use of ultrathin bronchoscopes has shown superiority over standard thin bronchoscopes. We retrospectively evaluated whether substitution of the thin-bronchoscope by the ultrathin device during multimodal bronchoscopy improves lesion ultrasound visualization and diagnostic yield in patients with difficult-to-approach pulmonary lesions. The study comprised 44 out of 338 patients that underwent multimodal bronchoscopy at Matsusaka Municipal Hospital. The thin-bronchoscope with an external diameter of 4 mm was substituted by the ultrathin-bronchoscope with an external diameter of 3 mm when the radial endobronchial ultrasound showed that the probe position was not within the target lesion. The median diameter of the pulmonary tumors was 17.5 mm (range: 6.0–5.2.0 mm). The endobronchial ultrasound showed the probe's position adjacent to the lesion in 12 cases and no visible lesion in 32 cases using a thin-bronchoscope. However, the endobronchial ultrasound views changed from adjacent to the lesion to within the lesion in nine cases, from no visible lesion to within the lesion in 17 cases, and from no visible lesion to adjacent to the lesion in nine cases after bronchoscope substitution. After substitution, the diagnostic yield was 80.8% in cases with the radial probe within the target lesion, 72.7% in cases with the probe adjacent to the target lesion, and 0% in cases with no visible lesion. The overall diagnostic yield was 65.9% after bronchoscope substitution. The substitution of the thin bronchoscope by the ultrathin device on a need basis improves the position of the radial endobronchial ultrasound probe and diagnostic yield of pulmonary lesions during multimodal diagnostic bronchoscopy.
format Online
Article
Text
id pubmed-7771655
institution National Center for Biotechnology Information
language English
publishDate 2020
publisher Frontiers Media S.A.
record_format MEDLINE/PubMed
spelling pubmed-77716552020-12-30 Use of Ultrathin Bronchoscope on a Need Basis Improves Diagnostic Yield of Difficult-to-Approach Pulmonary Lesions Nishii, Yoichi Nakamura, Yuki Fujiwara, Kentaro Ito, Kentaro Sakaguchi, Tadashi Suzuki, Yuta Furuhashi, Kazuki Kobayashi, Tetsu Yasuma, Taro D'Alessandro-Gabazza, Corina N. Gabazza, Esteban C. Asano, Fumihiro Taguchi, Osamu Hataji, Osamu Front Med (Lausanne) Medicine There are cases of peripheral lung nodules that are difficult to approach despite using ancillary diagnostic devices during multimodal bronchoscopy. The use of ultrathin bronchoscopes has shown superiority over standard thin bronchoscopes. We retrospectively evaluated whether substitution of the thin-bronchoscope by the ultrathin device during multimodal bronchoscopy improves lesion ultrasound visualization and diagnostic yield in patients with difficult-to-approach pulmonary lesions. The study comprised 44 out of 338 patients that underwent multimodal bronchoscopy at Matsusaka Municipal Hospital. The thin-bronchoscope with an external diameter of 4 mm was substituted by the ultrathin-bronchoscope with an external diameter of 3 mm when the radial endobronchial ultrasound showed that the probe position was not within the target lesion. The median diameter of the pulmonary tumors was 17.5 mm (range: 6.0–5.2.0 mm). The endobronchial ultrasound showed the probe's position adjacent to the lesion in 12 cases and no visible lesion in 32 cases using a thin-bronchoscope. However, the endobronchial ultrasound views changed from adjacent to the lesion to within the lesion in nine cases, from no visible lesion to within the lesion in 17 cases, and from no visible lesion to adjacent to the lesion in nine cases after bronchoscope substitution. After substitution, the diagnostic yield was 80.8% in cases with the radial probe within the target lesion, 72.7% in cases with the probe adjacent to the target lesion, and 0% in cases with no visible lesion. The overall diagnostic yield was 65.9% after bronchoscope substitution. The substitution of the thin bronchoscope by the ultrathin device on a need basis improves the position of the radial endobronchial ultrasound probe and diagnostic yield of pulmonary lesions during multimodal diagnostic bronchoscopy. Frontiers Media S.A. 2020-12-15 /pmc/articles/PMC7771655/ /pubmed/33385003 http://dx.doi.org/10.3389/fmed.2020.588048 Text en Copyright © 2020 Nishii, Nakamura, Fujiwara, Ito, Sakaguchi, Suzuki, Furuhashi, Kobayashi, Yasuma, D'Alessandro-Gabazza, Gabazza, Asano, Taguchi and Hataji. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Medicine
Nishii, Yoichi
Nakamura, Yuki
Fujiwara, Kentaro
Ito, Kentaro
Sakaguchi, Tadashi
Suzuki, Yuta
Furuhashi, Kazuki
Kobayashi, Tetsu
Yasuma, Taro
D'Alessandro-Gabazza, Corina N.
Gabazza, Esteban C.
Asano, Fumihiro
Taguchi, Osamu
Hataji, Osamu
Use of Ultrathin Bronchoscope on a Need Basis Improves Diagnostic Yield of Difficult-to-Approach Pulmonary Lesions
title Use of Ultrathin Bronchoscope on a Need Basis Improves Diagnostic Yield of Difficult-to-Approach Pulmonary Lesions
title_full Use of Ultrathin Bronchoscope on a Need Basis Improves Diagnostic Yield of Difficult-to-Approach Pulmonary Lesions
title_fullStr Use of Ultrathin Bronchoscope on a Need Basis Improves Diagnostic Yield of Difficult-to-Approach Pulmonary Lesions
title_full_unstemmed Use of Ultrathin Bronchoscope on a Need Basis Improves Diagnostic Yield of Difficult-to-Approach Pulmonary Lesions
title_short Use of Ultrathin Bronchoscope on a Need Basis Improves Diagnostic Yield of Difficult-to-Approach Pulmonary Lesions
title_sort use of ultrathin bronchoscope on a need basis improves diagnostic yield of difficult-to-approach pulmonary lesions
topic Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7771655/
https://www.ncbi.nlm.nih.gov/pubmed/33385003
http://dx.doi.org/10.3389/fmed.2020.588048
work_keys_str_mv AT nishiiyoichi useofultrathinbronchoscopeonaneedbasisimprovesdiagnosticyieldofdifficulttoapproachpulmonarylesions
AT nakamurayuki useofultrathinbronchoscopeonaneedbasisimprovesdiagnosticyieldofdifficulttoapproachpulmonarylesions
AT fujiwarakentaro useofultrathinbronchoscopeonaneedbasisimprovesdiagnosticyieldofdifficulttoapproachpulmonarylesions
AT itokentaro useofultrathinbronchoscopeonaneedbasisimprovesdiagnosticyieldofdifficulttoapproachpulmonarylesions
AT sakaguchitadashi useofultrathinbronchoscopeonaneedbasisimprovesdiagnosticyieldofdifficulttoapproachpulmonarylesions
AT suzukiyuta useofultrathinbronchoscopeonaneedbasisimprovesdiagnosticyieldofdifficulttoapproachpulmonarylesions
AT furuhashikazuki useofultrathinbronchoscopeonaneedbasisimprovesdiagnosticyieldofdifficulttoapproachpulmonarylesions
AT kobayashitetsu useofultrathinbronchoscopeonaneedbasisimprovesdiagnosticyieldofdifficulttoapproachpulmonarylesions
AT yasumataro useofultrathinbronchoscopeonaneedbasisimprovesdiagnosticyieldofdifficulttoapproachpulmonarylesions
AT dalessandrogabazzacorinan useofultrathinbronchoscopeonaneedbasisimprovesdiagnosticyieldofdifficulttoapproachpulmonarylesions
AT gabazzaestebanc useofultrathinbronchoscopeonaneedbasisimprovesdiagnosticyieldofdifficulttoapproachpulmonarylesions
AT asanofumihiro useofultrathinbronchoscopeonaneedbasisimprovesdiagnosticyieldofdifficulttoapproachpulmonarylesions
AT taguchiosamu useofultrathinbronchoscopeonaneedbasisimprovesdiagnosticyieldofdifficulttoapproachpulmonarylesions
AT hatajiosamu useofultrathinbronchoscopeonaneedbasisimprovesdiagnosticyieldofdifficulttoapproachpulmonarylesions