The modified biopsy technique conducting ultrasound bronchoscopy with endosonographic-guided position of the endoscopic instrument in the area of the pathological focus. The results of the first phase of the clinical trial

Abstract

Background. The problem of diagnostics and treatment of malignant neoplasms of the lungs is urgent. Verification of a malignant process in the case of peripheral localization of a neoplasm in the lung using ultrasound bronchoscopy ranges from 30 to 85%. To improve the efficiency of ultrasound bronchoscopy, a modified biopsy technique for ultrasound bronchoscopy was developed and introduced into clinical practice at the Chelyabinsk Regional Clinical Center of Oncology and Nuclear Medicine. The essence of the modified technique is that it becomes possible for ultrasound visual control over the passage and deployment of biopsy forceps in real time. The technique was patented, patent for invention RU №2719666 C1 was issued.
 Aim. To clarify the information content of ultrasound bronchoscopy using a modified technique.
 Materials and methods. On the basis of the endoscopic Department of Chelyabinsk Regional Clinical Center of Oncology and Nuclear Medicine in 2019 and 2020, ultrasound bronchoscopy using this technique was performed on 40 patients with suspected peripheral malignant neoplasm of the lungs. The diagnosis of malignant neoplasm was verified in 67.5% of cases. Using the standard biopsy technique, the probability of verification of lung malignant neoplasms in 2019 and 2020 was 57.7%. Thus, the modified biopsy technique made it possible to increase the verification probability by 9.8%. The modified technique is relatively safe, complications during the procedure were detected in 2 patients (in 3.8% of cases) and were successfully treated conservatively. During and after the procedure, the patients were monitored and monitored. The ultrasound bronchoscopy according to the modified technique was satisfactorily tolerated by the patients.
 Results. The period of examination of patients when using this technique does not increase. The technique replaces more invasive diagnostic procedures.
 Conclusion. The use of the modified technique will improve the information content of ultrasound bronchoscopy, shorten the examination time for patients and accelerate the appointment of special treatment methods.