Objective To evaluate the role of guide sheath (GS) utilization in radial endobronchial ultrasound guided transbronchial lung biopsy (EBUS-TBLB) for diagnosis of peripheral pulmonary lesions (PPLs). Methods The clinical data of patients who underwent EBUS-TBLB in Peking University First Hospital from July 2012 to June 2015 were retrospectively reviewed. The patients were divided into three groups,ie. a GS group, a non-GS group, and a double biopsy group. Results A total of 118 patients with 126 PPLs were collected. The overall diagnostic yield of EBUS-guided bronchoscopy was 60.3%. The diagnostic yield of GS group, non-GS group and double biopsy group was 65.4%(36/55), 61.5%(8/13), 59.6%(31/52), respectively. The diagnostic yield of the non-GS group was significantly lower than other two groups when PPLs≤20 mm (χ2=6.8,P=0.033), whereas no significant difference was observed when PPLs>20 mm (χ2=2.301,P=0.301). Conclusion GS significantly improves diagnostic yield in EBUS-TBLB when PPLs≤20 mm.
Peripheral pulmonary lesions (PPLs) are generally considered as lesions in the peripheral one-third of the lung. A computed tompgraphy (CT) guided transthoracic needle aspiration/biopsy or transbronchial approach using a bronchoscope has been the most generally accepted methods. Navigation technique can effectively improve the diagnosis rate of peripheral pulmonary lesions, reduce the incidence of complications, shorten the time of diagnosis, and make the patients get timely and effective treatment.
The detection of peripheral pulmonary lesions has increased gradually with the popularity of CT. Rapid and accurate diagnosis, and individualized treatment are two aspects we need to pay great attention to. These situations also raise higher request for the technique in diagnosis and treatment. At present, the commonly used transthoracic methods can increase the risk of complications such as pneumothorax and bleeding. The newly bronchoscopic approaches for diagnosis and treatment make less injury via natural lumen and have been applied widely in clinics. This review will introduce the worth expecting progress in bronchoscopic diagnosis and treatment for peripheral pulmonary lesions.