https://scholars.lib.ntu.edu.tw/handle/123456789/586919
標題: | Endobronchial ultrasound-guided transbronchial biopsy with or without a guide sheath for peripheral pulmonary malignancy | 作者: | CHUN-TA HUANG LIH-YU CHANG CHUNG-YU CHEN SHENG-YUAN RUAN CHING-KAI LIN Tsai, Yi-Ju CHAO-CHI HO CHONG-JEN YU |
公開日期: | 七月-2021 | 卷: | 7 | 期: | 3 | 來源出版物: | ERJ open research | 摘要: | Endobronchial ultrasound (EBUS)-guided transbronchial biopsy (TBB) is a common procedure used to diagnose peripheral pulmonary lesions (PPLs). However, existing literature did not conclusively show a difference in the ability of EBUS-TBB with and without a guide sheath (GS) to diagnose PPLs. This multicenter cohort study enrolled patients presenting for EBUS-TBB of PPLs that finally proved to be malignant. The diagnostic yield and complication rate were compared between patients undergoing EBUS-TBB with and without a GS (EBUS-TBB+GS versus EBUS-TBB-GS). A propensity score matching method was used to balance differences of pertinent clinical features between the two groups. The original cohort consisted of 975 patients (556 in EBUS-TBB-GS; 419 in EBUS-TBB+GS). GS guidance was more likely to be used with smaller (40 mm versus 44 mm) and middle or lower lobe (60% versus 35%) lesions. After propensity score matching, 720 (360 in each group) patients were included; the diagnostic yields for PPLs were 79% and 78% for EBUS-TBB-GS and EBUS-TBB+GS groups, respectively (p=0.649). The complication rates (5.8% versus 7.2% for bleeding; 0.6% versus 1.9% for pneumothorax) appeared to be lower in the EBUS-TBB+GS group, but the differences did not reach statistical significance. The procedure time was significantly longer in the EBUS-TBB+GS group than in the EBUS-TBB-GS group (29 min versus 24 min; p<0.001). In conclusion, adding a GS to EBUS-TBB did not improve the diagnostic yield for malignant PPLs. GS guidance was seemingly associated with a lower number of complications after TBB but contributed significantly to a longer procedure time. |
URI: | https://scholars.lib.ntu.edu.tw/handle/123456789/586919 | ISSN: | 2312-0541 | DOI: | 10.1183/23120541.00267-2021 | SDG/關鍵字: | aged; Article; bleeding; bronchoscopy; cohort analysis; diagnostic value; endobronchial ultrasonography; female; fluoroscopy; health auxiliary; histopathology; human; human tissue; lung cancer; male; multicenter study; peripheral lung lesion; pneumothorax; prospective study; retrospective study; software; transbronchial biopsy; ultrasound |
顯示於: | 醫學系 |
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