Mwesigwa Nicolas W, Tentzeris Vasileios, Gooseman Michael, Qadri Suhail, Maxine Read, Cowen Michael
Cardiothoracic Surgery, Hull University Teaching Hospitals, Hull, GBR.
Thoracic Surgery, Hull University Teaching Hospitals, Hull, GBR.
Cureus. 2024 Apr 15;16(4):e58289. doi: 10.7759/cureus.58289. eCollection 2024 Apr.
Electromagnetic navigational bronchoscopy (ENB) has emerged as an innovative technique for diagnosing peripheral and central nodules, offering an improved diagnostic yield compared to conventional bronchoscopy with fewer complications. That being said, pneumothorax remains a frequent complication. This retrospective study conducted at Castle Hill Hospital, UK, analysed ENB procedures over four years to assess the diagnostic yield and pneumothorax rates, exploring learning curves and procedural improvements specifically focusing on the diagnostic yield and pneumothorax rate as markers of change. A total of 246 patients underwent 358 peripheral lung biopsies, revealing an overall diagnostic yield of 61.3%. The diagnostic yield increased from 58.2% in 2020-2021 to 66.0% in 2022-2023 while the pneumothorax rate decreased significantly from 9.8% to 3.4% (p = 0.021*). The majority of pneumothorax cases occurred following upper lobe procedures. The study depicts the importance of procedural experience in improving outcomes, suggesting a learning curve effect. Additionally, it emphasizes the potential for technological advancements, such as robotic assistance, to mitigate operator-dependent variability and improve reproducibility in ENB procedures. These findings contribute to optimizing diagnostic pathways for lung lesions and improving patient safety in ENB interventions.
电磁导航支气管镜检查（ENB）已成为诊断外周和中央结节的一种创新技术，与传统支气管镜检查相比，其诊断率更高，并发症更少。话虽如此，气胸仍然是一种常见的并发症。这项在英国卡斯尔山医院进行的回顾性研究，分析了四年内的ENB手术，以评估诊断率和气胸发生率，探索学习曲线和手术改进，特别关注作为变化指标的诊断率和气胸发生率。共有246例患者接受了358次外周肺活检，总体诊断率为61.3%。诊断率从2020 - 2021年的58.2%提高到2022 - 2023年的66.0%，而气胸发生率从9.8%显著下降到3.4%（p = 0.021*）。大多数气胸病例发生在上叶手术后。该研究描述了手术经验对改善结果的重要性，表明存在学习曲线效应。此外，它强调了技术进步的潜力，如机器人辅助，以减轻操作者依赖的变异性，并提高ENB手术的可重复性。这些发现有助于优化肺部病变的诊断途径，并提高ENB干预中的患者安全性。
