Procedures: Procedures: Bronchoscopy |

Endobronchial Ultrasonography With or Without a Guide Sheath for Peripheral Pulmonary Lesions: A Prospective Randomized Crossover Study FREE TO VIEW

Sujuan Zhang; Jun Zhou
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The First People's Hospital of Changzhou, Changzhou, China

Copyright 2016, American College of Chest Physicians. All Rights Reserved.

Chest. 2016;149(4_S):A432. doi:10.1016/j.chest.2016.02.450
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SESSION TITLE: Procedures: Bronchoscopy

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Saturday, April 16, 2016 at 11:45 AM - 12:45 PM

PURPOSE: to compare the diagnostic yields and complications of transbronchial biopsies guided by radial endobronchial ultrasonography with a guide sheath (REBUS-GS-TBB) and with distance (REBUS-D-TBB) for peripheral pulmonary lesions (PPLs).

METHODS: Patients with PPLs identified by REBUS were enrolled in a prospective randomized crossover study. Once the lesion was localized, REBUS-GS-TBB and REBUS-D-TBB were performed sequentially in a randomized order in every patient. Fluoroscopy was not used during the procedures and, 2-4h after, a chest radiograph was finished. Length of time costed by procedure and complications such as bleeding, pneumothorax were recorded. Thin bronchoscopes with an outer diameter of 4 mm (BF-P-260F, Olympus) were used for all cases.

RESULTS: between Aug. 2014 and Jul. 2015, 54 consecutive patients with PPLs, who were referred to our hospital for diagnostic bronchoscopy, were included after written informed consent. 47 PPLs identified by REBUS underwent REBUS-GS-TBB and REBUS-D-TBB. The diagnostic yield was 83.0% (39/47, GS group) and 87.2% (41/47, D group) respectively (P=0.158). The mean biopsy time after visualization of PPLs was reduced in GS group [5.17 ± 2.34 (min) vs. 7.36 ± 3.18 (min), P=0.00053]. 5 cases of bleeding >50 ml were observed in REBUS-D-TBB group and none in REBUS-GS-TBB group. Pneumothorax was not occurred in this study.

CONCLUSIONS: REBUS-D-TBB appears to be equivalent to REBUS-GS-TBB for diagnosis of PPLs but the procedure time was longer. Further study should be performed to assess the risk of bleeding.

CLINICAL IMPLICATIONS: In comparison with REBUS-GS-TBB, REBUS-D-TBB is more cost-effective and more suitable in developing countries but attention has to be paid to bleeding.

DISCLOSURE: The following authors have nothing to disclose: Sujuan Zhang, Jun Zhou

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