Journal of Bronchology & Interventional Pulmonology最新文献

{"title":"\"Tool-in-lesion\" Accuracy of Galaxy System-A Robotic Electromagnetic Navigation BroncHoscopy With Integrated Tool-in-lesion-Tomosynthesis Technology: The MATCH Study.","authors":"Krish Bhadra, Otis B Rickman, Amit K Mahajan, Douglas Kyle Hogarth","doi":"10.1097/LBR.0000000000000923","DOIUrl":"10.1097/LBR.0000000000000923","url":null,"abstract":"<p><strong>Background: </strong>The Galaxy System (Noah Medical) is a novel robotic endoluminal platform using electromagnetic navigation combined with integrated tomosynthesis technology and augmented fluoroscopy. It provides intraprocedural imaging to correct computerized tomography (CT) to body divergence and novel confirmation of tool-in-lesion (TIL). The primary aim of this study was to assess the TIL accuracy of the robotic bronchoscope with integrated digital tomosynthesis and augmented fluoroscopy.</p><p><strong>Methods: </strong>Four operators conducted the experiment using 4 pigs. Each physician performed between 4 and 6 nodule biopsies for 20 simulated lung nodules with purple dye and a radio pacifier. Using Galaxy's \"Tool-in-Lesion Tomography (TOMO+)\" with augmented fluoroscopy, the physician navigated to the lung nodules, and a tool (needle) was placed into the lesion. TIL was defined by the needle in the lesion determined by cone-beam CT.</p><p><strong>Results: </strong>The lung nodule's average size was 16.3 ± 0.97 mm and was predominantly in the lower lobes (65%). All 4 operators successfully navigated to all (100%) of the lesions in an average of 3 minutes and 39 seconds. The median number of tomosynthesis sweeps was 3 and augmented fluoroscopy was utilized in most cases (17/20 or 85%). TIL after the final TOMO sweep was 95% (19/20) and tool-touch-lesion was 5% (1/20). Biopsy yielding purple pigmentation was also 100% (20/20).</p><p><strong>Conclusion: </strong>The Galaxy System demonstrated successful digital TOMO confirmed TIL success in 95% (19/20) of lesions and tool-touch-lesion in 5% (1/20) as confirmed by cone-beam CT. Successful diagnostic yield was achieved in 100% (20/20) of lesions as confirmed by intralesional pigment acquisition.</p>","PeriodicalId":15268,"journal":{"name":"Journal of Bronchology & Interventional Pulmonology","volume":" ","pages":"23-29"},"PeriodicalIF":3.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10763708/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9421623","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":"Assessing Factors That May Impact Physician-based Decisions for Placing Indwelling Pleural Catheters.","authors":"Matthew Alexander, Yoshiko Ishisaka, Lina Miyakawa, Adam Rothman","doi":"10.1097/LBR.0000000000000926","DOIUrl":"10.1097/LBR.0000000000000926","url":null,"abstract":"<p><strong>Introduction: </strong>Malignant pleural effusion is a common finding in patients with advanced cancer and is a frequent cause of dyspnea. Current guidelines indicate thoracentesis for symptomatic patients, while indwelling pleural catheters (IPC) are recommended for patients who develop pleural fluid re-accumulation. IPC maintenance, however, requires a significant level of financial and social support. This study aims to analyze potential influencing factors that may play a role in the decision for placing IPCs in patients with recurrent malignant pleural effusions.</p><p><strong>Methods: </strong>This study retrospectively collected baseline sociodemographic and laboratory data in patients who underwent thoracentesis for malignant pleural effusion from August 2016 to October 2021, and selected patients who presented with re-accumulation of pleural fluid within 30 days or had a pulmonary physician's note documenting that IPC is a potential management option. Of these selected patients (IPC candidates), we stratified patients who underwent IPC placement and those who did not, and performed statistical analysis between these 2 groups.</p><p><strong>Results: </strong>One hundred seventy-six patients who underwent thoracentesis were regarded as IPC candidates. Almost all baseline sociodemographic characteristics, including ethnicity ( P =0.637), sex ( P =0.655), and marital status ( P =0.773) were similar between the 2 groups, but significantly higher ECOG scores ( P =0.049) were noted in the IPC group. No statistically significant differences were noted in age, body mass index, platelet, PTT, international normalized ratio, creatinine, white blood cell, red blood cells, fluid protein, or fluid lactate dehydrogenase. Fluid albumin ( P =0.057) and serum neutrophil:lymphocyte ratio ( P =0.003) were significantly higher in patients without IPC placement.</p><p><strong>Conclusion: </strong>This study did not recognize any baseline sociodemographic factors that may contribute to the decision to place IPCs.</p>","PeriodicalId":15268,"journal":{"name":"Journal of Bronchology & Interventional Pulmonology","volume":" ","pages":"39-48"},"PeriodicalIF":3.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9840622","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":"Bite Damage to the Rigid Bronchoscope: A Report and Physics of an Extremely Rare Event.","authors":"Cristiano Cesaro, Umberto Caterino, Francesco Rossi, Umberto Masi, Fabio Perrotta, Enzo Zamparelli, Flavio Cesaro, Alfonso Fiorelli","doi":"10.1097/LBR.0000000000000947","DOIUrl":"10.1097/LBR.0000000000000947","url":null,"abstract":"","PeriodicalId":15268,"journal":{"name":"Journal of Bronchology & Interventional Pulmonology","volume":" ","pages":"88-90"},"PeriodicalIF":3.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41176321","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":"Multiple Pulmonary and Hepatic Cavernous Hemangiomas, Simulating a Disseminated Malignant Neoplasm.","authors":"Jesús Machuca-Aguado,&nbsp;Rafael López-Cano,&nbsp;Ana Triviño-Ramírez,&nbsp;José Luis Villar-Rodríguez","doi":"10.1097/LBR.0000000000000915","DOIUrl":"10.1097/LBR.0000000000000915","url":null,"abstract":"","PeriodicalId":15268,"journal":{"name":"Journal of Bronchology & Interventional Pulmonology","volume":" ","pages":"382-384"},"PeriodicalIF":3.3,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9557493","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":"Managing Medical Thoracoscopy Pain With Opioid-sparing Approaches.","authors":"Julie Lin,&nbsp;Horiana B Grosu","doi":"10.1097/LBR.0000000000000943","DOIUrl":"https://doi.org/10.1097/LBR.0000000000000943","url":null,"abstract":"","PeriodicalId":15268,"journal":{"name":"Journal of Bronchology & Interventional Pulmonology","volume":"30 4","pages":"318-320"},"PeriodicalIF":3.3,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41121769","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":"Cytological Diagnosis of Pulmonary Hydatid disease by Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration of Cyst Fluid.","authors":"Pinakjyoti Das,&nbsp;Prajwala Gupta,&nbsp;Desh Deepak","doi":"10.1097/LBR.0000000000000932","DOIUrl":"10.1097/LBR.0000000000000932","url":null,"abstract":"occasions diagnostic difficulties can arise with perivascular epithelioid cell tumors and alveolar sarcoma. Although this tumor type was initially described as benign and slow growing, with no tendency to recur, it has occasionally been shown to be malignant. The diagnosis of malignancy requires meeting at least 3 of the Fanburg-Smith criteria.10,11 None of the cases in our series could be considered malignant according to these criteria. However, respiratory GCTs can cause respiratory symptoms of type hemoptysis, cough, or dyspnea, which coupled with the fact that this tumor type lacks well-defined limits, can suggest a clinical diagnosis of malignancy (Table 1). In principle, the treatment for GCTs is not surgical, although the tumor size and certain pulmonary involvement could make surgery advisable. In this case, the surgery should be conservative. If the tumor is smaller than 8 mm, endoscopic resection is feasible. In the case of multiple lesions, clinical follow-up using imaging techniques and bronchoscopy are advisable. In our series, we opted for clinical follow-up for 2 patients, endoscopic polypectomy in 1 of them. In the 2 remaining patients, it was interpreted clinically that the tumor could be malignant and, therefore, proceeded to pulmonary bilobectomy. No complications resulting from the disease or surgery were detected in the follow-up period of at least 10 years. In summary, respiratory GCTs are benign neoplasms with a clear association with tobacco use and can arise as the consequence of chronic irritation of the bronchial nerves and whose treatment should be a clinical follow-up or endoscopic or surgical resection depending on tumor size, symptoms, and obstructive complications.","PeriodicalId":15268,"journal":{"name":"Journal of Bronchology & Interventional Pulmonology","volume":" ","pages":"392-397"},"PeriodicalIF":3.3,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9548525","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":"Bronchoscopic Management of Hemoptysis Caused by Airway Erosion From Vascular Coils.","authors":"Hussain Ahmed Raza,&nbsp;Mohummad H R Raja,&nbsp;Jefferson H Chambers,&nbsp;Chakravarthy B Reddy,&nbsp;Majid Shafiq","doi":"10.1097/LBR.0000000000000919","DOIUrl":"10.1097/LBR.0000000000000919","url":null,"abstract":"","PeriodicalId":15268,"journal":{"name":"Journal of Bronchology & Interventional Pulmonology","volume":" ","pages":"384-387"},"PeriodicalIF":3.3,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9603424","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":"Pleural Disease in Acute COVID-19 Pneumonia: A Single Center Retrospective Cohort Study.","authors":"Kai Swenson,&nbsp;Juan P Uribe,&nbsp;Alvaro Ayala,&nbsp;Mihir Parikh,&nbsp;Chenchen Zhang,&nbsp;Alichia Paton,&nbsp;Molly Trachtenberg,&nbsp;Adnan Majid","doi":"10.1097/LBR.0000000000000896","DOIUrl":"10.1097/LBR.0000000000000896","url":null,"abstract":"<p><strong>Background: </strong>Pleural diseases encompass pleural effusion and pneumothorax (PTX), both of which were uncommon in coronavirus disease of 2019 (COVID-19). We aimed to describe the frequency, characteristics, and main outcomes of these conditions in patients with COVID-19 pneumonia.</p><p><strong>Methods: </strong>We performed a retrospective cohort analysis of inpatients with COVID-19 pneumonia between January 1, 2020 and January 1, 2022, at Beth Israel Deaconess Medical Center in Boston, Massachusetts.</p><p><strong>Results: </strong>Among 4419 inpatients with COVID-19 pneumonia, 109 (2.5%) had concurrent pleural disease. Ninety-four (2.1%) had pleural effusion (50% seen on admission) and 15 (0.3%) had PTX, both with higher rates of underlying conditions such as heart failure, liver disease, kidney disease, and malignancy. A total of 28 (30%) pleural effusions were drained resulting in 32% being exudative, 43% pseudoexudative, and 25% transudative. Regarding PTX, 5 (33%) were spontaneous and 10 (67%) were due to barotrauma while on mechanical ventilation. We found that the presence of underlying lung disease was not associated with an increased risk of developing PTX. In addition, patients with pleural disease had a higher incidence of severe or critical illness as represented by intensive care unit admission and intubation, longer hospital and intensive care unit stay, and a higher mortality rate as compared with patients without the pleural disease.</p><p><strong>Conclusion: </strong>Pleural effusions and pneumothoraces are infrequent findings in patients admitted due to COVID-19 pneumonia, worsened outcomes in these patients likely reflect an interplay between the severity of inflammation and parenchymal injury due to COVID-19 disease and underlying comorbidities.</p>","PeriodicalId":15268,"journal":{"name":"Journal of Bronchology & Interventional Pulmonology","volume":" ","pages":"363-367"},"PeriodicalIF":3.3,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40393015","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":"Chartis-guided Endobronchial Valves Placement for Persistent Air Leak.","authors":"Mohamed Omballi,&nbsp;Zaid Noori,&nbsp;Regina V Alanis,&nbsp;Robert Lukken Imel,&nbsp;Fayez Kheir","doi":"10.1097/LBR.0000000000000914","DOIUrl":"10.1097/LBR.0000000000000914","url":null,"abstract":"","PeriodicalId":15268,"journal":{"name":"Journal of Bronchology & Interventional Pulmonology","volume":" ","pages":"398-400"},"PeriodicalIF":3.3,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10831768","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":"Current Practices Supporting Rigid Bronchoscopy-An International Survey.","authors":"Ismael Matus,&nbsp;Shannon Wilton,&nbsp;Elliot Ho,&nbsp;Haroon Raja,&nbsp;Lei Feng,&nbsp;Septimiu Murgu,&nbsp;Mona Sarkiss","doi":"10.1097/LBR.0000000000000881","DOIUrl":"10.1097/LBR.0000000000000881","url":null,"abstract":"<p><strong>Background: </strong>There are no guidelines for anesthesia or staff support needed during rigid bronchoscopy (RB). Identifying current practice patterns for RB pertinent to anesthesia, multidisciplinary teams, and algorithms of intra and post-procedural care may inform best practice recommendations.</p><p><strong>Methods: </strong>Thirty-three-question survey created obtaining practice patterns for RB, disseminated via email to the members of the American Association of Bronchology and Interventional Pulmonology and the American College of Chest Physicians Interventional Chest Diagnostic Procedures Network.</p><p><strong>Results: </strong>One hundred seventy-five clinicians participated. Presence of a dedicated interventional pulmonology (IP) suite correlated with having a dedicated multidisciplinary RB team ( P =0.0001) and predicted higher likelihood of implementing team-based algorithms for managing complications (39.4% vs. 23.5%, P =0.024). A dedicated anesthesiology team was associated with the increased use of high-frequency jet ventilation ( P =0.0033), higher likelihood of laryngeal mask airway use post-RB extubation ( P =0.0249), and perceived lower rates of postprocedural anesthesia adverse effects ( P =0.0170). Although total intravenous anesthesia was the most used technique during RB (94.29%), significant variability in the modes of ventilation and administration of muscle relaxants was reported. Higher comfort levels in performing RB are reported for both anesthesiologists ( P =0.0074) and interventional pulmonologists ( P =0.05) with the presence of dedicated anesthesia and RB supportive teams, respectively.</p><p><strong>Conclusion: </strong>Interventional bronchoscopists value dedicated services supporting RB. Multidisciplinary dedicated RB teams are more likely to implement protocols guiding management of intraprocedural complications. There are no preferred modes of ventilation during RB. These findings may guide future research on RB practices.</p>","PeriodicalId":15268,"journal":{"name":"Journal of Bronchology & Interventional Pulmonology","volume":" ","pages":"328-334"},"PeriodicalIF":3.3,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40664616","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}