PURPOSE: It has been suggested that ultrathin or thin bronchoscopy has a higher diagnostic yield than standard bronchoscopy in the diagnosis of peripheral pulmonary lesions. However, the small calibered working channel (1.2 mm) of now available thin bronchoscopes has the limitation of inadequate specimen collection. The aim of this study was to evaluate the diagnostic utility of a novel thin bronchoscope with a 1.7-mm working channel for peripheral pulmonary lesions.
METHODS: A total of 118 patients were included in this prospective study. Bronchoscopic examination using a standard bronchoscope was first performed. If there was no visible endobronchial lesion, then transbronchial biopsies were performed with a 1.5-mm biopsy forceps under fluoroscopic guidance and washing with 10-20 ml of saline solution, using a prototype 3.5-mm thin bronchoscope with a 1.7-mm working channel (XBF-3B40Y1; Olympus). All patients with benign diseases were followed for at least 1 year to determine the final diagnosis.
RESULTS: Endobronchial lesion was visualized with the standard bronchoscope in 16 patients, and residual 102 patients underwent biopsies with the thin bronchoscope. The mean bronchus level reached with the standard bronchoscope and the thin bronchoscope was 2.3th and 4.3th, respectively. Endobronchial abnormality was revealed with the thin bronchoscope in 14 patients. Diagnostic material was obtained in 50 of 68 patients (74%) with malignant disease and 19 of 30 patients (63%) with benign disease. Four patients did not return to follow-up. The diagnostic yield was 61% even in lesions < 20 mm. There were no major complications.
CONCLUSION: Bronchoscopy using a 3.5-mm thin bronchoscope with a 1.7-mm working channel is useful and safe for the diagnosis of peripheral pulmonary lesions.
CLINICAL IMPLICATIONS: This bronchoscope may be a useful alternative to a standard bronchoscope for examining peripheral pulmonary lesions.
DISCLOSURE: Masahide Oki, No Financial Disclosure Information; No Product/Research Disclosure Information