National Cancer Center, Division of Pulmonology, Center for Lung Cancer, Goyang, Republic of Korea.
Department of Nuclear Medicine, Pusan National University School of Medicine, Busan, Republic of Korea.
Thorac Cancer. 2022 Oct;13(20):2837-2843. doi: 10.1111/1759-7714.14622. Epub 2022 Aug 29.
Concurrent bronchoscopy using radial probe and convex endobronchial ultrasound (RP- and CP-EBUS) is used to simultaneously evaluate both peripheral lung lesions for the histological diagnosis of the primary tumor and mediastinal lymph nodes for mediastinal staging. So far, little is known about the combined procedure with RP- and CP-EBUS.
Between January 2020 and March 2021, the bronchoscopy database was reviewed to identify the clinical outcomes of the combined procedure with RP- and CP-EBUS. Patients who underwent transbronchial biopsy using RP-EBUS alone were classified as the RP-EBUS group, while those who underwent a combined procedure with RP- and CP-EBUS were classified as the combination group.
The overall diagnostic yield of the bronchoscopic procedure in the combination group was significantly higher than the RP-EBUS group (90.7% vs. 70.0%, p < 0.001). CP-EBUS increased the diagnostic yield of the bronchoscopic procedure in the combination group by 9.3%. Although the mean procedure time was significantly longer, and the mean doses of midazolam and fentanyl were significantly higher in the combination group (p < 0.001), there were no differences in the overall complication rates between the two study groups (1.4% and 1.0% for the RP-EBUS and combination groups, respectively, p = 0.766).
Combined bronchoscopy using RP- and CP-EBUS is feasible and safe. In addition to mediastinal staging, CP-EBUS increased the overall diagnostic yield of the bronchoscopic procedure by 9.3%.
径向探头和凸面支气管内超声(RP- 和 CP-EBUS)联合支气管镜检查用于同时评估外周肺病变以进行原发性肿瘤的组织学诊断和纵隔淋巴结以进行纵隔分期。到目前为止,对于 RP- 和 CP-EBUS 的联合操作知之甚少。
2020 年 1 月至 2021 年 3 月,对支气管镜检查数据库进行了回顾,以确定 RP- 和 CP-EBUS 联合操作的临床结果。仅接受 RP-EBUS 经支气管活检的患者被归类为 RP-EBUS 组,而接受 RP- 和 CP-EBUS 联合操作的患者被归类为联合组。
联合组支气管镜检查的总体诊断率明显高于 RP-EBUS 组(90.7%对 70.0%,p < 0.001)。CP-EBUS 将联合组支气管镜检查的诊断率提高了 9.3%。尽管联合组的平均操作时间明显延长,咪达唑仑和芬太尼的平均剂量明显更高(p < 0.001),但两组的总体并发症发生率无差异(RP-EBUS 组和联合组分别为 1.4%和 1.0%,p = 0.766)。
RP- 和 CP-EBUS 联合支气管镜检查是可行且安全的。除了纵隔分期外,CP-EBUS 还将支气管镜检查的总体诊断率提高了 9.3%。