Author of

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  P3.17 - Poster Session 3 - Bronchoscopy, Endoscopy (ID 185)

  • Event: WCLC 2013
  • Type: Poster Session
  • Track:
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/30/2013, 09:30 - 16:30, Exhibit Hall, Ground Level

  • 12764

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    P3.17-005 - Diagnostic Yield of Flexible Bronchoscopy in Evaluating Peripheral Lung Lesions Without Endobronchial Lesions (ID 2131)

    09:30 - 09:30  |  Author(s): M.S. Kim
    • Abstract

    Background
    The diagnosis of peripheral lung lesions (PPLs) continues to be a commom problem in routine clinical practice. Despite bronchoscopy with guidance has evolved from fluoroscopy to endobronchial ultrasonography and electromagnetic navigation recently, conventional flexible bronchoscopy without guidance is still the most widely used because it is more readily available and inexpensive. The aim of this study was to evaluate the diagnostic yield and factors affecting diagnostic yield of flexible bronchoscopy without guidance for peripheral lung lesions.

    Methods
    We retrospectively reviewed the medical records of all the patients who underwent flexible bronchoscopy at St. Paul’s hospital of the Catholic University of Korea between Jan 2007 and Mar 2013. Two hundred four patients had lung lesions without endobronchial lesion. Among these, 24 patients were excluded due to follow-up loss and additional 11 patients were excluded because the lesions were deemed inactive in clinical follow up.

    Results
    One hundred sixty-eight patients were enrolled in this study. The overall diagnostic rate was 58.3%. Sensitivity was 43.2% in malignant disease and 78.1% in benign disease. Non-diagnostic results of bronchoscopy were compared with subsequent PCNA or surgical resection. Nodule location and the distance from the pleura did not effect on the diagnostic yield of bronchoscopy. The bronchus sign on CT imaging was present in 45.7% of the patients. The diagnostic yield was significantly higher for lesions with bronchus sign (81.2%) than for lesions not having bronchus sign (39.0%; P<0.001). The diagnostic yield of bronchoscopy increased according to different ranges of lesion diameter; 10 mm or smaller, 11-20 mm, 21-30 mm, 31-40 mm, 41-50 mm, and greater than 50mm were 16.7%, 32.0%, 50.0%, 57.1%, and 58.8% respectively (linear P<0.001). The diagnostic yield was significantly higher for lesions >3 cm (67.5%) than for lesions <3cm (47.9%; P < 0.02).

    Conclusion
    This study suggests that the presence of bronchus sign and larger (>30 mm) nodule are useful findings to predict outcome of conventional bronchoscopy without guidance.