Faculty Collaboration Database

Electromagnetic navigation bronchoscopy performed by thoracic surgeons: one center's early success. Ann Thorac Surg 2012 Mar;93(3):944-9; discussion 949-50

Date

01/27/2012

Pubmed ID

22277964

DOI

10.1016/j.athoracsur.2011.11.006

Scopus ID

2-s2.0-84857536356 (requires institutional sign-in at Scopus site)   60 Citations

Abstract

BACKGROUND: Multiple studies by pulmonologists have demonstrated that electromagnetic navigation bronchoscopy (ENB) can, with high diagnostic yields and low complication rates, diagnose pulmonary lesions. We believe thoracic surgeons can perform this technique with excellent early results.

METHODS: A retrospective analysis was conducted of the first consecutive 104 patients undergoing diagnostic ENB by 2 thoracic surgeons between April 2008 and October 2009. Procedures utilized general anesthesia and rapid on-site examination (ROSE) of cytopathology. All pulmonary lesions were suspicious for malignancy. Patients having negative biopsies subsequently underwent additional procedures or follow-up imaging. True negative biopsies were defined as lesions removed surgically and proven benign, lesions that disappeared on subsequent imaging, and lesions demonstrating stability over a 2-year period.

RESULTS: Of 104 patients, 3 were excluded due to insufficient follow-up. The remaining 101 patients had a median lesion size of 2.8 cm. Sixty-seven (82%) of the 82 lesions that were determined malignant had a positive diagnosis upon ENB. Of the 34 lesions without a positive ENB biopsy, 19 (56%) were categorized as true negatives: 8 had benign surgical biopsies, 6 disappeared, and 5 demonstrated stability. Consequently, 86 of 101 cases had an accurate ENB biopsy for a diagnostic yield of 85%. There was insufficient evidence to demonstrate an association between lesion size and diagnostic accuracy. There were 6 pneumothoraces (5.8%).

CONCLUSIONS: It is possible for thoracic surgeons to perform ENB with early success. The high diagnostic yields in this study may be attributed to the routine utilization of ROSE and general anesthesia, which preserves computed tomographic-to-body divergence.

Author List

Pearlstein DP, Quinn CC, Burtis CC, Ahn KW, Katch AJ

Author

Kwang Woo Ahn PhD Professor in the Institute for Health and Equity department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Aged
Aged, 80 and over
Bronchoscopy
Electromagnetic Fields
Female
Humans
Lung Diseases
Male
Middle Aged
Predictive Value of Tests
Retrospective Studies
Thoracic Surgery
Thoracic Surgical Procedures