The Evaluation of the Diagnostic Yield and Complications Associated with Bronchoscopy via Endobronchial Ultrasound with a Guide Sheath.

Abstract

Background and objective Endobronchial ultrasound with a guide sheath (EBUS-GS) is used to accurately position a bronchoscope in lung lesions using a guide sheath. Previous studies have focused on diagnostic success as the endpoint. The achievement of 'within' defined as reaching the lesion, is considered crucial in EBUS-GS procedures. This study investigated cases wherein 'within' is likely to be achieved and cases that can be diagnosed after achieving 'within'. Methods This retrospective study evaluated 258 bronchoscopic examinations using EBUS-GS. We analyzed the relationship between patient background, lesion size and characteristics, achieving 'within', definitive diagnosis after achieving 'within', and complications. Results and Conclusion A multivariate analysis revealed that lesion size ≥20 mm (odds ratio 12, 95% confidence interval [CI]: 6.0-21, p<0.01) and lesions with solid components (odds ratio 13, 95% CI: 1.3-120, p=0.03) were associated with achieving 'within'. For cancer cases, lesion size ≥20 mm was associated with a higher diagnostic rate following achieving 'within' than smaller lesions (odds ratio 4.23, 95% CI: 1.38-12.9, p=0.01). The occurrence of complications was linked to lesion size ≥20 mm (odds ratio 2.7, 95% CI: 1.02-6.9, p=0.045). The factors associated with 'within'-achieving bronchoscopy via EBUS-GS included lesion size ≥20 mm and solid components. Larger lesions were associated with a definitive diagnosis. Lesion size was a determinant in improving diagnostic rates, both for achieving within and for successful diagnosis after achieving 'within'.