ELECTROMAGNETIC NAVIGATIONAL (EMN) BRONCHOSCOPY AND EMN PERCUTANEOUS TRANSTHORACIC NEEDLE BIOPSY OF THE CHEST LESION: THE FIRST 102 CONSECUTIVE EARLY EXPERIENCE CASES

Abstract

SESSION TITLE: Wednesday Abstract Posters SESSION TYPE: Original Investigation Posters PRESENTED ON: 10/23/2019 09:45 AM - 10:45 AM PURPOSE: The recent advent of electromagnetic navigation (EMN) systems can be used to facilitate both bronchoscopic and transthoracic access for biopsy in a single operative setting. We report our early experience with EMN bronchoscopy and percutaneous transthoracic needle biopsy by a single surgeon. METHODS: The present study is a retrospective cohort analysis of the first 102 patients to undergo navigational bronchoscopy and /or percutaneous transthoracic interventions utilizing EMN system guidance between January 2018 and March 2019. Indications, success rate and complications were reviewed. RESULTS: A total 102 EMN procedures were performed by a single surgeon without fluoroscopy and radial endobronchial ultrasounds. Indications for EMN included biopsy of lung lesions 94, pleural lesions 7, and one for chest wall lesion. Of the ninety-four lung lesions, two underwent EMN percutaneous biopsy as the initial procedure without navigational bronchoscopy. Eighty-eight cases 95.6% (88/92) successfully reached the target by bronchoscopy under image guidance. The diagnostic yield for EMN bronchoscopy biopsy for nodules was 72.8 % (67/92). Twenty cases 22% (20/92) were converted to the percutaneous transthoracic core needle biopsy. The diagnostic yield for the patients who had percutaneous transthoracic biopsy was 90% (18/20). The combined diagnostic yield rate for EMN bronchoscopic and percutaneous lung biopsy was 92.3% (85/92). Diagnostic yield for pleural-based lesions by percutaneous transthoracic biopsy was 75% (6/8) with pleura thickness of 16±2 mm (16-20 mm). The only complication encountered in this series was pneumothorax after percutaneous transthoracic biopsy for the lung lesions requiring chest tube in 2 patients (10%). CONCLUSIONS: In our initial series of 102 cases by a single surgeon, EMN guided endobronchial and transthoracic needle biopsy for the chest lesions showed an acceptable diagnostic yield and minimal complications. The diagnostic yield rate was raised approximately 20 % by concurrent percutaneous transthoracic needle biopsy for the lung lesion. CLINICAL IMPLICATIONS: Performance in a single operative setting as an alternative diagnostic procedure has the potential to decrease time to diagnosis and numbers of procedural visits, ultimately streamlining care for the patient. DISCLOSURES: no disclosure on file for Raphael Bueno; No relevant relationships by Michael Jaklitsch, source=Web Response No relevant relationships by Ciaran McNamee, source=Admin input No relevant relationships by Carolyn Moore, source=Web Response no disclosure on file for Hisashi Tsukada; No relevant relationships by Brian Whang, source=Web Response no disclosure on file for Daniel Wiener