A study of the diagnostic value of endobronchial ultrasound guide sheath transbronchial lung biopsy combined with virtual bronchoscopic navigation in peripheral pulmonary lesions

Abstract

To evaluate the diagnostic value of endobronchial ultrasound guide sheath transbronchial lung biopsy (EBUS-GS-TBLB) combined with virtual bronchoscopic navigation (VBN) in peripheral pulmonary lesions (PPLs). Cases with a PPL identified by computed tomography in Affiliated Hospital of Medical College of Ningbo University underwent EBUS-GS-TBLB with or without VBN randomly between Nov. 2014 to Aug. 2015. X-ray guidance was not performed in these cases. The sensitivity and the operation time were evaluated in the 2 groups. A total of 184 patients were enrolled and completed this study. Among them 117 were males and 67 were females. There were 93 cases in the group of EBUS-GS-TBLB with VBN, and 91 in the group without VBN. The diagnostic sensitivity of VBN group was 72.04%(67/93). Among these positive cases, 64.1% cases (43/67) were malignant tumors, and 35.9% cases (24/67) were benign lesions. The mean operation time was (45±10)min. In the group without VBN, the diagnostic sensitivity was 69.23%(63/91), including 33 malignant tumors(52.4%, 33/63), and 30 benign lesions(47.6%, 30/63). The mean operation time was (55±10)min. There was no significant difference between EBUS-GS-TBLB with VBN group and EBUS-GS-TBLB without VBN group in diagnostic sensitivity (χ(2)=0.175, P=0.747). But there was a significant difference in the mean operation time between the 2 groups (t=6.522, P<0.001). EBUS-GS-TBLB was well tolerated. No severe procedure-related complications such as pneumothorax and hemoptysis were observed. VBN cannot improve the diagnostic sensitivity, but it can clear the location of lesion, and shorten the operation time. This technique helps to abandon the X-ray guidance. EBUS-GS-TBLB combined with VBN is a safe and effective technique for PPLs.