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• W4387247905 abstract "SESSION TITLE: Procedures Posters 3 SESSION TYPE: Original Investigation Posters PRESENTED ON: 10/10/2023 12:00 pm - 12:45 pm PURPOSE: The diagnostic yield of bronchoscopy for peripheral lung lesions has been augmented by new technologies. However, the most efficient and cost-effective approach has not been determined. We present the results of incorporating ultrathin bronchoscope alongside conventional bronchoscopy, radial endobronchial ultrasound (rEBUS), and 2D fluoroscopy. METHODS: We conducted a retrospective study to assess the impact of adding ultrathin bronchoscope (Olympus BF-MP190F, 3.0 mm distal-end outer diameter with a 1.7 mm working channel diameter) on the results of bronchoscopy for peripheral lung lesions in our practice in a tertiary care university hospital. In this study, our routine approach for diagnosing such lesions included the use of a thin bronchoscope (4.2 mm outer diameter) with radial endobronchial ultrasound (rEBUS) under fluoroscopy surveillance. CT scans were reviewed before the procedure to find the approximate location of the lesion and guide the bronchoscopist for navigation towards the target. In cases where an optimal concentric rEBUS view, indicative of successful placement of the diagnostic tool inside the lesion, was not achieved, we employed the ultrathin bronchoscope. Sampling was performed using needle aspirations and forceps biopsies. The primary outcome measure was diagnostic yield, defined as the successful detection of malignancy or a specific benign diagnosis, such as sarcoidosis or fungal infection. Cases with non-specific results, such as inflammation, atypical cells, or organizing pneumonia, were considered unsuccessful unless a surgical biopsy produced similar results, or the lesion remained stable or decreased in size during at least 12 months of imaging follow-up. The secondary outcome measure was the attainment of a concentric rEBUS view. RESULTS: This study enrolled 123 patients who underwent bronchoscopy for peripheral lung lesions between March 2019 and January 2021. The CT scan results showed that the median longest diameter in axial plane was 22mm, with the smallest nodule measuring 7mm. The median distance from the closest visceral pleura was 15mm. Diagnostic yield was 81.3%. Concentric rEBUS view was found in 114 cases (92.7%). There was only one instance of pneumothorax post-procedure, and no other major complications were reported. CONCLUSIONS: The addition of ultrathin bronchoscope to the combination of thin bronchoscope, rEBUS and 2D fluoroscopy has shown promise in enhancing the localization of small and hard-to-reach lung lesions during peripheral airway bronchoscopy. This relatively low-cost approach has resulted in a high diagnostic yield comparable to emerging robotics and other technologies. Further multicenter studies are recommended to compare this technique with other technologies, with a focus on assessing the diagnostic yield and cost benefits. CLINICAL IMPLICATIONS: Despite the emergence of various advanced bronchoscopy technologies, the differentiation between benign and malignant lung nodules remains challenging. Moreover, the high cost of some of the new technologies presents a barrier to their widespread utilization in healthcare systems worldwide. However, combining bronchoscopy using thin and ultrathin scopes with radial EBUS guidance and routine fluoroscopy could provide an efficient method for the early detection of lung cancer. This combination of tools is affordable and could be utilized in the global fight against lung cancer. DISCLOSURES: No disclosure on file for Christine Chan No relevant relationships by Gabriel Hernández Romero No disclosure on file for Mimi Kim Consultant relationship with Olympus America Please note: 6 years Added 03/29/2023 by Ali Sadoughi, source=Web Response, value=consultant fee Removed 03/29/2023 by Ali Sadoughi, source=Web Response consultant relationship with Olympus America Please note: 6 years Added 03/29/2023 by Ali Sadoughi, source=Web Response, value=consultant fee Consultant relationship with Noah Medical Please note: 2 years Added 03/29/2023 by Ali Sadoughi, source=Web Response, value=consultant fee Consultant relationship with Mauna Kea Please note: 1 year Added 03/29/2023 by Ali Sadoughi, source=Web Response, value=Consulting fee Consultant relationship with Ambu Please note: 2 year Added 03/29/2023 by Ali Sadoughi, source=Web Response, value=Consulting fee consultant relationship with Siemens Healthineers Please note: 1 year Added 03/30/2023 by Ali Sadoughi, source=Web Response, value=Honoraria Consultant relationship with Alpha Tau Medical Please note: 3 years Added 03/30/2023 by Ali Sadoughi, source=Web Response, value=Grant/Research Support No relevant relationships by David Schecter No relevant relationships by Shwe Synn" @default.
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• W4387247905 date "2023-10-01" @default.
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• W4387247905 title "USING ULTRA-THIN BRONCHOSCOPE INCREASES DIAGNOSTIC YIELD IN PERIPHERAL AIRWAY BRONCHOSCOPY" @default.
• W4387247905 doi "https://doi.org/10.1016/j.chest.2023.07.3424" @default.
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