https://scholars.lib.ntu.edu.tw/handle/123456789/510386
標題: | The value of repeat radial-probe endobronchial ultrasound-guided transbronchial biopsy after initial non-diagnostic results in patients with peripheral pulmonary lesions | 作者: | CHUN-TA HUANG Tsai Y.-J. CHAO-CHI HO CHONG-JEN YU |
公開日期: | 2017 | 出版社: | BioMed Central Ltd. | 卷: | 17 | 期: | 1 | 來源出版物: | BMC Pulmonary Medicine | 摘要: | Background: Radial-probe endobronchial ultrasound (rEBUS)-guided transbronchial biopsy (TBB) is invaluable in the diagnosis of peripheral pulmonary lesions (PPLs); however, in certain instances, the procedure has to be repeated because of initial non-diagnostic procedure(s). Little if any literature has been published on this issue. Therefore, the aim of this study was to investigate the utility of repeat rEBUS-guided TBB in achieving a definitive diagnosis of PPLs. Methods: All patients who underwent rEBUS-guided TBB of PPLs at National Taiwan University Hospital between 2011 and 2015 and had a repeat procedure after non-diagnostic initial procedures were identified as the study subjects. The primary outcome of interest was the diagnostic yield of repeat rEBUS-guided TBB for PPLs. Also, we sought to discover features associated with the yield of repeat procedures. Results: Forty-three (11%) out of 384 patients with initial non-diagnostic TBB were included for analysis. A diagnosis of PPLs was able to be confirmed with repeat TBB in 23(53%) patients. The pathology of the first TBB was significantly associated with the yield of repeat procedures (P = 0.011). Further, patients with normal lung tissue in initial pathology rarely (2/12, 17%) had a definite diagnosis on repeat TBB. Yet, patients with pathology showing atypical cells and other non-specific findings were more likely (21/31, 68%) to obtain a confirmed diagnosis. The diagnostic yield of repeat procedures was not affected by the size, location or CT appearance of the lesions, or position of the rEBUS probe. No death or other serious adverse events occurred with the repeat rEBUS-guided procedures. Conclusions: If clinically indicated, it is reasonable to repeat rEBUS-guided TBB after an initial non-diagnostic procedure as the diagnostic yield will be at least 50% and the side effect profile is favorable. ? 2017 The Author(s). |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-85031678948&doi=10.1186%2fs12890-017-0478-3&partnerID=40&md5=440ca25d35bf1fa1a4dcb7a8bf2a26fa https://scholars.lib.ntu.edu.tw/handle/123456789/510386 |
ISSN: | 1471-2466 | DOI: | 10.1186/s12890-017-0478-3 | SDG/關鍵字: | aged; Article; bleeding; chronic inflammation; clinical article; clinical feature; cohort analysis; computer assisted tomography; diagnostic test accuracy study; diagnostic value; endobronchial ultrasonography; female; granulomatous inflammation; human; human tissue; image guided biopsy; lung fibrosis; male; outcome assessment; peripheral lung lesion; pneumothorax; predictive value; radial probe endobronchial ultrasound; repeat procedure; retrospective study; Taiwan; tissue necrosis; transbronchial biopsy; bronchoscopy; diagnostic imaging; echography; lung; lung disease; middle aged; pathology; tertiary care center; x-ray computed tomography; Aged; Bronchoscopy; Female; Humans; Image-Guided Biopsy; Lung; Lung Diseases; Male; Middle Aged; Retrospective Studies; Taiwan; Tertiary Care Centers; Tomography, X-Ray Computed; Ultrasonography |
顯示於: | 醫學系 |
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