Journal of Bronchology & Interventional Pulmonology最新文献

{"title":"Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration Leading to Mediastinitis Causing Critical Airway Obstruction.","authors":"Alejandro J Torre De León, Herik Valles Bastidas, Horiana B Grosu","doi":"10.1097/LBR.0000000000000967","DOIUrl":"10.1097/LBR.0000000000000967","url":null,"abstract":"","PeriodicalId":15268,"journal":{"name":"Journal of Bronchology & Interventional Pulmonology","volume":"31 3","pages":""},"PeriodicalIF":3.3,"publicationDate":"2024-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141076048","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pulmonary Inflammatory Myofibroblastic Tumor: A Pathological Dilemma.","authors":"Varun Bhalla, Amnah Khalid, Victor Perez, Ruoqing Huang, Muhammad Perwaiz","doi":"10.1097/LBR.0000000000000963","DOIUrl":"10.1097/LBR.0000000000000963","url":null,"abstract":"","PeriodicalId":15268,"journal":{"name":"Journal of Bronchology & Interventional Pulmonology","volume":"31 3","pages":""},"PeriodicalIF":3.3,"publicationDate":"2024-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140869939","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robotic-assisted Navigation Bronchoscopy: A Meta-Analysis of Diagnostic Yield and Complications: Erratum.","authors":"","doi":"10.1097/LBR.0000000000000965","DOIUrl":"https://doi.org/10.1097/LBR.0000000000000965","url":null,"abstract":"","PeriodicalId":15268,"journal":{"name":"Journal of Bronchology & Interventional Pulmonology","volume":"327 ","pages":"231"},"PeriodicalIF":3.3,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140767640","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Flexible CO2 Laser in Therapeutic Bronchoscopy: Initial Experiences in a Tertiary Center.","authors":"Gabriel Ortiz-Jaimes, John Mullon, Darlene Nelson, Janani Reisenauer, David Midthun, Eric Edell, Dagny Anderson, Maria Vargas-Brochero, Robert Petrossian, Ryan Kern","doi":"10.1097/LBR.0000000000000962","DOIUrl":"10.1097/LBR.0000000000000962","url":null,"abstract":"<p><strong>Background: </strong>CO2 Laser (CO2L) technology deployable through flexible endoscopes now allows for their use throughout the airway, although published data are limited.</p><p><strong>Methods: </strong>Retrospective analysis of CO2L bronchoscopic procedures, excluding glottic and subglottic interventions. Procedural success was defined as >50% visual reduction in airway obstruction in the area treated or resolution of the procedural indication.</p><p><strong>Results: </strong>Seventy-two procedures were performed on 36 patients. Nonmalignant indications comprised 66%: stent-associated granulation tissue (28%), granulomatosis with polyangiitis lesions (23%), and lung transplant-related granulation tissue (16%) were the most common. Bronchoscopic access was flexible only in 81% and primarily rigid (combined with flexible) in 18%. The site of intervention was the trachea at 19%, the mainstem at 56%, and lobar/segmental airways at 45%. Procedural success was 89%. CO2L was used exclusively in 19%; in 81%, additional techniques were required, most commonly balloon dilation (59%), cryo-debulking (23%), and rigid dilation (16%). Malignant indications had a nonsignificant trend toward requiring adjuvant techniques ( P =0.05). Seventy-six percent of the patients required more than 1 procedure. CO2L exclusive cases had no statistically different needs for subsequent therapeutic bronchoscopies ( P =0.10) or time to reintervention (109 vs. 41 days, P =0.07), and reintervention-free survival was similar ( P =0.10) and difficult to predict. The complication rate attributable to CO2L was 2.7%.</p><p><strong>Conclusion: </strong>CO2L is a safe and useful tool when precise cutting and vaporization are desired. Its use in multi-modality approaches has high levels of success in adequately selected lesions, adding an ablative potential to dilation techniques. Vasculitis-associated scars/webs and granulation tissue (including stent-associated) appear to be ideal targets.</p>","PeriodicalId":15268,"journal":{"name":"Journal of Bronchology & Interventional Pulmonology","volume":" ","pages":"205-214"},"PeriodicalIF":3.3,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139048806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety of Home Discharge With a Chest Tube After Bronchoscopic Lung Volume Reduction Complicated by Persistent Airleak.","authors":"Amit Bobby Mahajan, Mahwish Bari, Nancy Collar, Shourjo Chakravorty, Duy K Duong, Kei Suzuki, Priya P Patel, Michael J Weyant, Douglas K Hogarth","doi":"10.1097/LBR.0000000000000945","DOIUrl":"10.1097/LBR.0000000000000945","url":null,"abstract":"<p><strong>Background: </strong>The incidence of pneumothorax after bronchoscopic lung volume reduction (BLVR) using Zephyr (Pulmonx Corporation) endobronchial valves is ~26%. Many patients who develop a postprocedural pneumothorax require chest tube placement. If a persistent airleak is present, patients tolerating waterseal can be discharged home with a mini-atrium with a low risk of empyema.</p><p><strong>Methods: </strong>Data were collected on patients from the Epic (Epic System Corporation) electronic medical record between July 2019 and November 2022. Our retrospective study reviewed a total of 102 BLVR procedures. Twenty-six of these procedures were complicated by a pneumothorax post-BLVR (25%). After 24 procedures, patients were discharged home with a chest tube after a persistent airleak. The primary endpoint of the study was the incidence of intrapleural infection in this population. The secondary endpoint was the average length of time the chest tube was in place until outpatient removal.</p><p><strong>Results: </strong>Out of the 24 discharge events, 2 events (8.3%) were complicated by an intrapleural infection before chest tube removal. The average number of days requiring a chest tube until outpatient removal was 16.9 days, which is similar to the duration observed in patients discharged home with a chest tube after lung volume reduction surgery.</p><p><strong>Conclusion: </strong>Discharging patients home with a chest tube after BLVR therapy is safe and may reduce hospital length of stay. Our study shows the incidence of intrapleural infection after home discharge with a chest tube after BLVR is low.</p>","PeriodicalId":15268,"journal":{"name":"Journal of Bronchology & Interventional Pulmonology","volume":" ","pages":"126-131"},"PeriodicalIF":3.3,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10223860","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preoperative Workup of Patients With Excessive Central Airway Collapse: Does Stent Evaluation Serve a Role?","authors":"Jennifer M Pan, Daniel Ospina-Delgado, Sumedh Kaul, Mihir S Parikh, Jennifer L Wilson, Adnan Majid, Sidhu P Gangadharan","doi":"10.1097/LBR.0000000000000935","DOIUrl":"10.1097/LBR.0000000000000935","url":null,"abstract":"<p><strong>Background: </strong>Tracheobronchoplasty (TBP) is a definitive anatomic intervention for patients with severe symptomatic expiratory central airway collapse. Although stent evaluations have been described for surgical workup, current literature does not address if improvement during stent evaluation is sustained after TBP. We compared health-related quality of life (HRQOL) and functional status responses after airway stenting to those post-TBP.</p><p><strong>Methods: </strong>A retrospective review was performed in patients with severe expiratory central airway collapse who underwent stent evaluation followed by TBP from January 2004 to December 2019. Baseline, poststent, 3- and 12-month postoperative HRQOL scores, and functional status were analyzed with statistical tests as appropriate.</p><p><strong>Results: </strong>One hundred twenty patients underwent a stent evaluation and TBP. Baseline and stent evaluation measurements were compared with statistically and clinically significant differences in the Cough Quality-of-life Questionnaire (CQLQ) (55 vs. 68, P <0.01), Modified Medical Research Council (mMRC) 0 to 2 (90% vs. 47%, P <0.01), 6-minute walk test (6MWT) (1301 ft vs. 1138 ft, P <0.01). Improvements in the HRQOL and functional status were maintained from stent evaluation to 3 months postoperatively [CQLQ 55 vs. 54, P =0.63; mMRC 0 to 2 (87% vs. 84%), P =0.39; 6MWT 1350 ft vs. 1314 ft, P =0.33], and 12 months postoperatively [CQLQ 54 vs. 54, P =0.91; mMRC 0 to 2 (95% vs. 86%), P =0.74; 6MWT 1409 ft vs. 1328 ft, P =0.13]. The magnitude of change between the data was not significantly different between the stent evaluation, 3-, and 12 months postoperative. Predicted forced expiratory volume in 1-second measurements at baseline, after stent placement, 3 months, and 12 months post-TBP were 74%, 79%, 73%, and 73%, respectively, and not clinically significant.</p><p><strong>Conclusions: </strong>Improvement after stent evaluation and the magnitude of improvement may be predictive of postoperative outcomes up to 1 year after surgery.</p>","PeriodicalId":15268,"journal":{"name":"Journal of Bronchology & Interventional Pulmonology","volume":" ","pages":"146-154"},"PeriodicalIF":3.3,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9755154","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Cone Beam CT Bronchoscopy Study of the Ultrathin Cryoprobe for Biopsy of Peripheral Lung Lesions.","authors":"Krish Bhadra, Randolph M Setser, William Condra, Brittany Amento Bader, Stephanie David","doi":"10.1097/LBR.0000000000000936","DOIUrl":"10.1097/LBR.0000000000000936","url":null,"abstract":"<p><strong>Background: </strong>Compared with the standard cryoprobe, the novel ultrathin 1.1 mm cryoprobe (UTCP) has improved ergonomics, shape memory, and flexibility. The performance of UTCP has demonstrated promising results in several small trials.</p><p><strong>Methods: </strong>In this single-center, retrospective review, we examine 200 (N=200) consecutive patients referred for cone beam CT bronchoscopic biopsy of peripheral lung lesions. We utilized an extended multimodality approach, including transbronchial needle aspirate, brush, traditional forces biopsies, UTCP biopsies, and BAL. We analyzed tool in lesion, tool touch lesion, center strike rates, and diagnostic yield. We assessed for molecular adequacy and analyzed safety.</p><p><strong>Results: </strong>A total of 222 lesions were biopsied. We achieved a tool in lesion or tool touch lesion confirmation for all biopsy attempts (100%) and a center strike rate of 68%. AQuIRE diagnostic yield was 90%, with 60% malignant, 30% benign lung nodules, and 10% nondiagnostic. UTCP was diagnostic in 3.6 % of peripheral lung lesions biopsies when all other modalities were nondiagnostic; thus, raising our overall diagnostic yield from 86.4% to 90.1%. Our analysis demonstrates superior adequacy for molecular analysis for histologic samples (TBBX or UTCP) versus cytologic samples (FNA) ( P <0.001). Three patients (1.5%) had a pneumothorax, and 1 patient (0.5%) had moderate bleeding.</p><p><strong>Conclusion: </strong>UTCP was diagnostic in 3.6% of peripheral lung lesions when all other modalities were nondiagnostic. In the setting of CBCT guidance, UTCP has a similar safety profile to standard biopsy tools. Future trials are warranted to assess UTCP and its impact on peripheral lung lesion biopsies.</p>","PeriodicalId":15268,"journal":{"name":"Journal of Bronchology & Interventional Pulmonology","volume":" ","pages":"117-125"},"PeriodicalIF":3.3,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10984630/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9775541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Single Institution Evaluation of Electromagnetic Navigation Bronchoscopy for Diagnosis of Pulmonary Lesions.","authors":"Anthony Greco, Clarissa B Smith, Xiaosong Shi, Maykol Postigo","doi":"10.1097/LBR.0000000000000957","DOIUrl":"10.1097/LBR.0000000000000957","url":null,"abstract":"<p><strong>Background: </strong>Electromagnetic navigation bronchoscopy (ENB) utilizes three-dimensional reconstructions based on computed tomography to guide the biopsy of pulmonary lesions. Various limitations have been described; however, supporting data have been limited by small sample sizes.</p><p><strong>Methods: </strong>Cases of ENB for evaluation of a pulmonary lesion at a single institution during a 1-year span were reviewed for demographics, lesion location, procedural details, and final tissue diagnosis. ENB was performed by 3 pulmonologists using the Veran platform with rapid on-site evaluation. T test or Mann-Whitney U test compared continuous variables and χ 2 or Fisher exact test compared categorical variables as appropriate. A patient with a negative or inconclusive biopsy was followed for 1 year postprocedure.</p><p><strong>Results: </strong>A total of 107 pulmonary lesions were evaluated. The population studied had a mean age of 67 and a median pulmonary lesion size of 26.0 mm. For malignant lesions, the pathologic diagnostic yield from ENB was 52.1% (37/71). The diagnostic yield of benign lesions was much lower at 16.7% (6/36). The overall procedural complication rate was 8.4% (9/107). Complications were more likely to occur in patients with malignant lesions. The most common complication was pneumothorax, occurring in 5.6% of all biopsies and 7.0% of patients with malignant lesions.</p><p><strong>Conclusion: </strong>This study demonstrates significant differences in diagnostic accuracy between lesions found to be malignant versus benign. Our observed complication rate was slightly higher than other groups have reported, with a greater frequency occurring in patients with malignant lesions; however, the rate of pneumothorax was still lower than computed tomography-guided transcutaneous biopsies.</p>","PeriodicalId":15268,"journal":{"name":"Journal of Bronchology & Interventional Pulmonology","volume":" ","pages":"139-145"},"PeriodicalIF":3.3,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138444806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diffuse Large B-cell Lymphoma Presenting as Bronchial Mass.","authors":"Claire X Chen, Gwendoline Amsrala, Arthur O Romero","doi":"10.1097/LBR.0000000000000958","DOIUrl":"10.1097/LBR.0000000000000958","url":null,"abstract":"","PeriodicalId":15268,"journal":{"name":"Journal of Bronchology & Interventional Pulmonology","volume":" ","pages":"224-227"},"PeriodicalIF":3.3,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10984628/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138444805","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of Pleural Space Infections in Patients With Indwelling Pleural Catheters for Active Malignancies.","authors":"Christopher H Chang, David E Ost, Carlos A Jimenez, Sahara N Saltijeral, Georgie A Eapen, Roberto F Casal, Bruce F Sabath, Julie Lin, Eben Cerrillos, Tamara Nevarez Tinoco, Horiana B Grosu","doi":"10.1097/LBR.0000000000000956","DOIUrl":"10.1097/LBR.0000000000000956","url":null,"abstract":"<p><strong>Background: </strong>Pleural infections related to indwelling pleural catheters (IPCs) are an uncommon clinical problem. However, management decisions can be complex for patients with active malignancies due to their comorbidities and limited life expectancies. There are limited studies on the management of IPC-related infections, including whether to remove the IPC or use intrapleural fibrinolytics.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of patients with active malignancies and IPC-related empyemas at our institution between January 1, 2005 and May 31, 2021. The primary outcome was to evaluate clinical outcomes in patients with malignant pleural effusions and IPC-related empyemas treated with intrapleural tissue plasminogen activator (tPA) and deoxyribonuclease (DNase) compared with those treated with tPA alone or no intrapleural fibrinolytic therapy. The secondary outcome evaluated was the incidence of bleeding complications.</p><p><strong>Results: </strong>We identified 69 patients with a malignant pleural effusion and an IPC-related empyema. Twenty patients received tPA/DNase, 9 received tPA alone, and 40 were managed without fibrinolytics. Those treated with fibrinolytics were more likely to have their IPCs removed as part of the initial management strategy ( P =0.004). The rate of surgical intervention and mortality attributable to the empyema were not significantly different between treatment groups. There were no bleeding events in any group.</p><p><strong>Conclusion: </strong>In patients with IPC-related empyemas, we did not find significant differences in the rates of surgical intervention, empyema-related mortality, or bleeding complications in those treated with intrapleural tPA/DNase, tPA alone, or no fibrinolytics. More patients who received intrapleural fibrinolytics had their IPCs removed, which may have been due to selection bias.</p>","PeriodicalId":15268,"journal":{"name":"Journal of Bronchology & Interventional Pulmonology","volume":" ","pages":"155-159"},"PeriodicalIF":3.3,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138047040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}