PURPOSE:Peripheral pulmonary lesions are technically challenged with conventional bronchoscopy in obtaining tissue diagnosis. The recently developed small-caliber ultrasonographic probe can be introduced via the working channel of the flexible bronchoscope to localize peripheral pulmonary lesions (PPLs) prior to diagnostic techniques including transbronchial lung biopsy (TBB). The endobronchial ultrasound-guided transbronchial lung biopsy (EBUS-TBB) is a new diagnostic method for the diagnosis of pulmonary lesion sin our center. we investigated the diagnostic yield of EBUS-guided TBB in pulmonary lesions.
METHODS:This was a prospective cross-sectional study. We enrolled sixty-two patients with pulmonary lesions that were beyond the segmental bronchus and had no significant bronchoscopic finding (no evidence of endobronchial lesion), who underwent bronchoscopy in our center. WEith EBUS assisted transbronchial lung biopsy was performed after localizing and measuring diatance from the tip of bronchoscope to the lesion. The diagnostic yield was calculated and compared.
RESULTS:Pulmonary lesions were visible on EBUS image in 98.0%. The overall diagnostic yield of EBUS-TBB was 51.6%. The diagnostic yield in the infiltrative and mass lesions were 82.4% and 40.0%, respectively. Lesions which had higher diagnostic yield included lesion located in left lung,EBUS probe located within and benign lesions as compare to lesion located inright lung,EBUS probe located adjacent to and malignant lesions.the average EBUS time was 3.95+/-2.82 minutes. No complication of EBUS and transbronchial lung biopsy were observed in this study.
CONCLUSION:EBUS-TBB is a new modality for diagnosing pulmonary lesions.Our results indicate that the improves the diagnostic yield compared to conventional bronchoscopy.
CLINICAL IMPLICATIONS:EBUS-TBB may be used in bronchoscopy in patient with pulmonary lesion but other adjunctive tool such as fluoroscopy and guided-sheath should be consider to further increase the diagnostic yield.
DISCLOSURE:Jamsak Tscheikuna, None.