Cargando…
Utility and safety of sole electromagnetic navigation bronchoscopy under moderate sedation for lung cancer diagnosis
BACKGROUND: Electromagnetic navigation bronchoscopy (ENB) is an emerging technique for diagnosing pulmonary lesions. However, limited data is available on its sole utility under a least invasive setting without general anesthesia. We aimed to evaluate the diagnostic performance and safety of sole EN...
Autores principales: | , , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
AME Publishing Company
2022
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8988087/ https://www.ncbi.nlm.nih.gov/pubmed/35399563 http://dx.doi.org/10.21037/tlcr-21-846 |
_version_ | 1784682885859508224 |
---|---|
author | Kim, Yeon Wook Kim, Hyung-Jun Song, Myung Jin Kwon, Byoung Soo Lim, Sung Yoon Lee, Yeon Joo Park, Jong Sun Cho, Young-Jae Yoon, Ho Il Lee, Jae Ho Lee, Choon-Taek |
author_facet | Kim, Yeon Wook Kim, Hyung-Jun Song, Myung Jin Kwon, Byoung Soo Lim, Sung Yoon Lee, Yeon Joo Park, Jong Sun Cho, Young-Jae Yoon, Ho Il Lee, Jae Ho Lee, Choon-Taek |
author_sort | Kim, Yeon Wook |
collection | PubMed |
description | BACKGROUND: Electromagnetic navigation bronchoscopy (ENB) is an emerging technique for diagnosing pulmonary lesions. However, limited data is available on its sole utility under a least invasive setting without general anesthesia. We aimed to evaluate the diagnostic performance and safety of sole ENB under moderate sedation for diagnosing pulmonary lesions suspicious for lung cancer and to determine clinical factors associated with a better diagnostic yield. METHODS: We performed a retrospective analysis of consecutive patients who underwent sole ENB under moderate sedation for lung lesion biopsy between August 2016 and June 2021 at Seoul National University Bundang Hospital, a tertiary center in South Korea. Diagnostic yield of the ENB-guided biopsy, safety endpoints defined by the incidence and severity of associated complications, and factors associated with higher diagnostic yield were evaluated. RESULTS: A total of 94 patients were evaluated. The final diagnostic yield of ENB was 81.5% (75/92), excluding two indeterminate cases. The diagnostic yield ranged from 79.8% to 81.9% assuming all indeterminate cases were false-negatives (79.8%) and true-negatives (81.9%). The sensitivity and specificity for malignancy were 77.6% (ranging from 75.6% to 77.6%) and 100%, respectively. Any-grade pneumothorax occurred in 4.3% of the patients, and 2.1% developed pneumothorax requiring additional intervention. Multivariable analyses identified the presence of a class 2 bronchus sign as the only significant predictor for a higher diagnostic yield (odds ratio =4.83, 95% CI: 1.16–20.12). The diagnostic yield of ENB among those with class 2 bronchus sign was 89.8% (53/59). CONCLUSIONS: Sole ENB under moderate sedation for diagnosing pulmonary lesions displayed a good diagnostic yield and safety profile, thus confirming its utility in a least-invasive setting. Moreover, sole ENB could be possibly be superior to transthoracic needle aspiration for diagnosing lesions with class 2 bronchus sign accounting for similar yields and lower complication rates. |
format | Online Article Text |
id | pubmed-8988087 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | AME Publishing Company |
record_format | MEDLINE/PubMed |
spelling | pubmed-89880872022-04-08 Utility and safety of sole electromagnetic navigation bronchoscopy under moderate sedation for lung cancer diagnosis Kim, Yeon Wook Kim, Hyung-Jun Song, Myung Jin Kwon, Byoung Soo Lim, Sung Yoon Lee, Yeon Joo Park, Jong Sun Cho, Young-Jae Yoon, Ho Il Lee, Jae Ho Lee, Choon-Taek Transl Lung Cancer Res Original Article BACKGROUND: Electromagnetic navigation bronchoscopy (ENB) is an emerging technique for diagnosing pulmonary lesions. However, limited data is available on its sole utility under a least invasive setting without general anesthesia. We aimed to evaluate the diagnostic performance and safety of sole ENB under moderate sedation for diagnosing pulmonary lesions suspicious for lung cancer and to determine clinical factors associated with a better diagnostic yield. METHODS: We performed a retrospective analysis of consecutive patients who underwent sole ENB under moderate sedation for lung lesion biopsy between August 2016 and June 2021 at Seoul National University Bundang Hospital, a tertiary center in South Korea. Diagnostic yield of the ENB-guided biopsy, safety endpoints defined by the incidence and severity of associated complications, and factors associated with higher diagnostic yield were evaluated. RESULTS: A total of 94 patients were evaluated. The final diagnostic yield of ENB was 81.5% (75/92), excluding two indeterminate cases. The diagnostic yield ranged from 79.8% to 81.9% assuming all indeterminate cases were false-negatives (79.8%) and true-negatives (81.9%). The sensitivity and specificity for malignancy were 77.6% (ranging from 75.6% to 77.6%) and 100%, respectively. Any-grade pneumothorax occurred in 4.3% of the patients, and 2.1% developed pneumothorax requiring additional intervention. Multivariable analyses identified the presence of a class 2 bronchus sign as the only significant predictor for a higher diagnostic yield (odds ratio =4.83, 95% CI: 1.16–20.12). The diagnostic yield of ENB among those with class 2 bronchus sign was 89.8% (53/59). CONCLUSIONS: Sole ENB under moderate sedation for diagnosing pulmonary lesions displayed a good diagnostic yield and safety profile, thus confirming its utility in a least-invasive setting. Moreover, sole ENB could be possibly be superior to transthoracic needle aspiration for diagnosing lesions with class 2 bronchus sign accounting for similar yields and lower complication rates. AME Publishing Company 2022-03 /pmc/articles/PMC8988087/ /pubmed/35399563 http://dx.doi.org/10.21037/tlcr-21-846 Text en 2022 Translational Lung Cancer Research. All rights reserved. https://creativecommons.org/licenses/by-nc-nd/4.0/Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) . |
spellingShingle | Original Article Kim, Yeon Wook Kim, Hyung-Jun Song, Myung Jin Kwon, Byoung Soo Lim, Sung Yoon Lee, Yeon Joo Park, Jong Sun Cho, Young-Jae Yoon, Ho Il Lee, Jae Ho Lee, Choon-Taek Utility and safety of sole electromagnetic navigation bronchoscopy under moderate sedation for lung cancer diagnosis |
title | Utility and safety of sole electromagnetic navigation bronchoscopy under moderate sedation for lung cancer diagnosis |
title_full | Utility and safety of sole electromagnetic navigation bronchoscopy under moderate sedation for lung cancer diagnosis |
title_fullStr | Utility and safety of sole electromagnetic navigation bronchoscopy under moderate sedation for lung cancer diagnosis |
title_full_unstemmed | Utility and safety of sole electromagnetic navigation bronchoscopy under moderate sedation for lung cancer diagnosis |
title_short | Utility and safety of sole electromagnetic navigation bronchoscopy under moderate sedation for lung cancer diagnosis |
title_sort | utility and safety of sole electromagnetic navigation bronchoscopy under moderate sedation for lung cancer diagnosis |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8988087/ https://www.ncbi.nlm.nih.gov/pubmed/35399563 http://dx.doi.org/10.21037/tlcr-21-846 |
work_keys_str_mv | AT kimyeonwook utilityandsafetyofsoleelectromagneticnavigationbronchoscopyundermoderatesedationforlungcancerdiagnosis AT kimhyungjun utilityandsafetyofsoleelectromagneticnavigationbronchoscopyundermoderatesedationforlungcancerdiagnosis AT songmyungjin utilityandsafetyofsoleelectromagneticnavigationbronchoscopyundermoderatesedationforlungcancerdiagnosis AT kwonbyoungsoo utilityandsafetyofsoleelectromagneticnavigationbronchoscopyundermoderatesedationforlungcancerdiagnosis AT limsungyoon utilityandsafetyofsoleelectromagneticnavigationbronchoscopyundermoderatesedationforlungcancerdiagnosis AT leeyeonjoo utilityandsafetyofsoleelectromagneticnavigationbronchoscopyundermoderatesedationforlungcancerdiagnosis AT parkjongsun utilityandsafetyofsoleelectromagneticnavigationbronchoscopyundermoderatesedationforlungcancerdiagnosis AT choyoungjae utilityandsafetyofsoleelectromagneticnavigationbronchoscopyundermoderatesedationforlungcancerdiagnosis AT yoonhoil utilityandsafetyofsoleelectromagneticnavigationbronchoscopyundermoderatesedationforlungcancerdiagnosis AT leejaeho utilityandsafetyofsoleelectromagneticnavigationbronchoscopyundermoderatesedationforlungcancerdiagnosis AT leechoontaek utilityandsafetyofsoleelectromagneticnavigationbronchoscopyundermoderatesedationforlungcancerdiagnosis |