¿Influye la experiencia del operador en la rentabilidad de la broncoscopia en el diagnóstico de lesiones pulmonares focales malignas?

Abstract

IntroductionThe fiberoptic bronchoscopy (FB) is a useful technique in the diagnosis of focal pulmonary nodules and masses. The profitability of the FB and transbronchial biopsy (TB) is variable and depends on different factors such as the operator's experience. The aim of this study was to determine if the diagnostic profitability of these techniques, in the diagnosis of malignant focal pulmonary lesions (FPL), changed with the incorporation of a new medical staff compared with previous data of our center. Material and methodsA FPL was defined as an intra - parenchymatous pulmonary lesion that is well circumscribed and completely surrounded by healthy lung.We analyzed all the FBs between 02/2008 and 08/2009 in patients with a FPL with a definitive diagnosis of malignancy. 85 patients were included. ResultsThe diagnostic profitability of the TB was 0.55; it was higher when the FPL was > 2cm (≤ 2cm vs > 2cm; 0.38 vs 0.62; p=0.02) but no difference was found by site (central vs. peripheral; 0.67 vs 0.54; p=0.16). The previous profitability of TB was 0.76 without differences by size (≤ 2cm vs > 2cm; 0.72 vs 0,78; p=0,48) or site (central vs peripheral; 0.83 vs 0.74; p=0,39). ConclusionWe conclude that the operator's experience influences in the diagnostic profitability of the TB, in the malignant FPL.