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Mediastinal Cryobiopsy for Pathological Diagnosis of Fibrosing Mediastinitis-Associated Pulmonary Hypertension. 纵隔冷冻活组织切片用于纤维性纵隔炎相关肺动脉高压的病理诊断
IF 3.5 3区 医学
Respiration Pub Date : 2024-01-01 Epub Date: 2024-01-25 DOI: 10.1159/000535395
Ya-Ting You, Hao Zuo, Jing-Meng Li, Xian-Bo Zhu, Jing Zhang, Wan-Lei Fu, Zan-Sheng Huang, Felix J Herth, Ye Fan
{"title":"Mediastinal Cryobiopsy for Pathological Diagnosis of Fibrosing Mediastinitis-Associated Pulmonary Hypertension.","authors":"Ya-Ting You, Hao Zuo, Jing-Meng Li, Xian-Bo Zhu, Jing Zhang, Wan-Lei Fu, Zan-Sheng Huang, Felix J Herth, Ye Fan","doi":"10.1159/000535395","DOIUrl":"10.1159/000535395","url":null,"abstract":"<p><strong>Introduction: </strong>Fibrosing mediastinitis is a benign but fatal disorder characterized by the proliferation of fibrous tissue in the mediastinum, causing encasement of mediastinal organs and extrinsic compression of adjacent bronchovascular structures. FM-associated pulmonary hypertension (FM-PH) is a serious complication of FM, resulting from the external compression of lung vessels. Pathologic assessment is important for etiologic diagnosis and effective treatment of this disease.</p><p><strong>Case presentation: </strong>A 59-year-old male patient presented at our hospital and was diagnosed with FM-PH. He declined surgical biopsy that is the reference standard for pathologic assessment, in consideration of the potential risks. Therefore, an endobronchial ultrasound examination was performed, which identified the subcarinal lesion. Under ultrasound guidance, four needle aspirations were carried out, followed by one cryobiopsy. Histopathological examination of transbronchial needle aspiration specimens was inconclusive, while samples from cryobiopsy suggested a diagnosis of idiopathic FM. Further immunophenotyping demonstrated the infiltration of lymphocytes, macrophages, and FOXP3-positive cells in FM-PH.</p><p><strong>Conclusion: </strong>Mediastinal cryobiopsy might be a novel and safe option for FM-PH patients who are unwilling or unsuitable for surgical procedure.</p>","PeriodicalId":21048,"journal":{"name":"Respiration","volume":" ","pages":"95-99"},"PeriodicalIF":3.5,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10871676/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139562896","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The Wound Healing of Autologous Regenerative Factor on Recurrent Benign Airway Stenosis: A Canine Experimental and Pilot Study. 自体再生因子对复发性良性气道狭窄的伤口愈合:一项犬实验和试点研究
IF 3.5 3区 医学
Respiration Pub Date : 2024-01-01 Epub Date: 2024-02-09 DOI: 10.1159/000536007
Xiaobo Chen, Wenhao Wang, Yongshun Ye, Yixi Yang, Difei Chen, Ruiting He, Zhulin Xiao, Jingwei Liu, Tingting Xu, Yongna Cai, Haiqi Feng, Changgao Zhong, Weiqun Xiao, Yingying Gu, Liya Lu, Hailin Xiong, Zhiyong Zhang, Shiyue Li
{"title":"The Wound Healing of Autologous Regenerative Factor on Recurrent Benign Airway Stenosis: A Canine Experimental and Pilot Study.","authors":"Xiaobo Chen, Wenhao Wang, Yongshun Ye, Yixi Yang, Difei Chen, Ruiting He, Zhulin Xiao, Jingwei Liu, Tingting Xu, Yongna Cai, Haiqi Feng, Changgao Zhong, Weiqun Xiao, Yingying Gu, Liya Lu, Hailin Xiong, Zhiyong Zhang, Shiyue Li","doi":"10.1159/000536007","DOIUrl":"10.1159/000536007","url":null,"abstract":"<p><strong>Introduction: </strong>Benign airway stenosis (BAS) is a severe pathologic condition. Complex stenosis has a high recurrence rate and requires repeated bronchoscopic interventions for achieving optimal control, leading to recurrent BAS (RBAS) due to intraluminal granulation.</p><p><strong>Methods: </strong>This study explored the potential of autologous regenerative factor (ARF) for treating RBAS using a post-intubation tracheal stenosis canine model. Bronchoscopic follow-ups were conducted, and RNA-seq analysis of airway tissue was performed. A clinical study was also initiated involving 17 patients with recurrent airway stenosis.</p><p><strong>Results: </strong>In the animal model, ARF demonstrated significant effectiveness in preventing further collapse of the injured airway, maintaining airway patency and promoting tissue regeneration. RNA-seq results showed differential gene expression, signifying alterations in cellular components and signaling pathways. The clinical study found that ARF treatment was well-tolerated by patients with no severe adverse events requiring hospitalization. ARF treatment yielded a high response rate, especially for post-intubation tracheal stenosis and idiopathic tracheal stenosis patients.</p><p><strong>Conclusion: </strong>The study concludes that ARF presents a promising, effective, and less-invasive method for treating RBAS. ARF has shown potential in prolonging the intermittent period and reducing treatment failure in patients with recurrent tracheal stenosis by facilitating tracheal mucosal wound repair and ameliorating tracheal fibrosis. This novel approach could significantly impact future clinical applications.</p>","PeriodicalId":21048,"journal":{"name":"Respiration","volume":" ","pages":"111-123"},"PeriodicalIF":3.5,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139717836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Advances in the Treatment of Pulmonary Nodules. 肺结节的治疗进展。
IF 3.5 3区 医学
Respiration Pub Date : 2024-01-01 Epub Date: 2024-02-21 DOI: 10.1159/000535824
Quncheng Zhang, Xuan Wu, Huizhen Yang, Peiyuan Luo, Nan Wei, Shuai Wang, Xingru Zhao, Ziqi Wang, Felix J F Herth, Xiaoju Zhang
{"title":"Advances in the Treatment of Pulmonary Nodules.","authors":"Quncheng Zhang, Xuan Wu, Huizhen Yang, Peiyuan Luo, Nan Wei, Shuai Wang, Xingru Zhao, Ziqi Wang, Felix J F Herth, Xiaoju Zhang","doi":"10.1159/000535824","DOIUrl":"10.1159/000535824","url":null,"abstract":"<p><strong>Background: </strong>Early detection and accurate diagnosis of pulmonary nodules are crucial for improving patient outcomes. While surgical resection of malignant nodules is still the preferred treatment option, it may not be feasible for all patients. We aimed to discuss the advances in the treatment of pulmonary nodules, especially stereotactic body radiotherapy (SBRT) and interventional pulmonology technologies, and provide a range of recommendations based on our expertise and experience.</p><p><strong>Summary: </strong>Interventional pulmonology is an increasingly important approach for the management of pulmonary nodules. While more studies are needed to fully evaluate its long-term outcomes and benefits, the available evidence suggests that this technique can provide a minimally invasive and effective alternative for treating small malignancies in selected patients. We conducted a systematic literature review in PubMed, designed a framework to include the advances in surgery, SBRT, and interventional pulmonology for the treatment of pulmonary nodules, and provided a range of recommendations based on our expertise and experience.</p><p><strong>Key messages: </strong>As such, alternative therapeutic options such as SBRT and ablation are becoming increasingly important and viable. With recent advancements in bronchoscopy techniques, ablation via bronchoscopy has emerged as a promising option for treating pulmonary nodules. This study reviewed the advances of interventional pulmonology in the treatment of peripheral lung cancer patients that are not surgical candidates. We also discussed the challenges and limitations associated with ablation, such as the risk of complications and the potential for incomplete nodule eradication. These advancements hold great promise for improving the efficacy and safety of interventional pulmonology in treating pulmonary nodules.</p>","PeriodicalId":21048,"journal":{"name":"Respiration","volume":" ","pages":"134-145"},"PeriodicalIF":3.5,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139932660","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Components of the Chronic Obstructive Pulmonary Disease Assessment Test Associated with the Exacerbation of Severe Chronic Obstructive Pulmonary Disease Patients. 与严重慢性阻塞性肺病患者病情加重有关的慢性阻塞性肺病评估测试的组成部分。
IF 3.5 3区 医学
Respiration Pub Date : 2024-01-01 Epub Date: 2024-03-12 DOI: 10.1159/000538330
Na Young Kim, Junhee Han, Yong Il Hwang, Yong Bum Park, Seoung Ju Park, Jimyung Park, Ki-Suck Jung, Kwang Ha Yoo, Jin Hwa Lee, Chang Youl Lee
{"title":"Components of the Chronic Obstructive Pulmonary Disease Assessment Test Associated with the Exacerbation of Severe Chronic Obstructive Pulmonary Disease Patients.","authors":"Na Young Kim, Junhee Han, Yong Il Hwang, Yong Bum Park, Seoung Ju Park, Jimyung Park, Ki-Suck Jung, Kwang Ha Yoo, Jin Hwa Lee, Chang Youl Lee","doi":"10.1159/000538330","DOIUrl":"10.1159/000538330","url":null,"abstract":"<p><strong>Introduction: </strong>The chronic obstructive pulmonary disease (COPD) Assessment Test (CAT) score is widely used for evaluating the health status of patients diagnosed with COPD. The aim of this study was to identify which components of the CAT are associated with exacerbations in severe COPD patients.</p><p><strong>Methods: </strong>Using data from the Korean COPD Subgroup Study (KOCOSS), we identified 3,440 COPD patients, among which 1,027 patients are classified as having severe COPD based on spirometry results. The CAT scores on 8 items were evaluated and classified into respiratory and non-respiratory categories. We analyzed the association between CAT item scores and moderate-to-severe exacerbations during study enrollment and the following years.</p><p><strong>Results: </strong>Patients with a history of moderate-to-severe exacerbations had higher scores on non-respiratory CAT components. Longitudinal CAT scores on all items after enrollment were higher in the moderate-to-severe exacerbation group. Additionally, the frequency of severe exacerbations was associated with specific CAT components related to limited activities, confidence leaving home, sleeplessness, and energy.</p><p><strong>Conclusions: </strong>This study revealed that the non-respiratory CAT component scores were statistically significant factors for predicting the moderate-to-severe exacerbation of severe COPD patients. Non-respiratory symptoms and functional limitations should be considered in patients with severe COPD. Interventions, such as pulmonary rehabilitation, may be needed to improve patients' overall well-being and prevent exacerbations.</p>","PeriodicalId":21048,"journal":{"name":"Respiration","volume":" ","pages":"326-335"},"PeriodicalIF":3.5,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140111290","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Early Pneumatocele Identification Post-Robotic Assisted Bronchoscopy Cryobiopsy: A Case Series Experience. 机器人辅助支气管镜冷冻活组织检查后的早期气胸识别:病例系列经验。
IF 3.5 3区 医学
Respiration Pub Date : 2024-01-01 Epub Date: 2024-03-12 DOI: 10.1159/000538272
Arvind Balavenkataraman, Ana Garza Salas, Alanna Barrios Ruiz, Prasanth Balasubramanian, Sebastian Fernandez-Bussy, David Abia Trujillo
{"title":"Early Pneumatocele Identification Post-Robotic Assisted Bronchoscopy Cryobiopsy: A Case Series Experience.","authors":"Arvind Balavenkataraman, Ana Garza Salas, Alanna Barrios Ruiz, Prasanth Balasubramanian, Sebastian Fernandez-Bussy, David Abia Trujillo","doi":"10.1159/000538272","DOIUrl":"10.1159/000538272","url":null,"abstract":"<p><strong>Introduction: </strong>The use of cryobiopsy in conjunction with robotic assisted bronchoscopy is on the rise due to the safety and increased diagnostic yield of cryobiopsy. The incorporation of 3D fluoroscopy in the procedure improves the workflow and helps confirm the accuracy of sampling of peripheral pulmonary nodules.</p><p><strong>Methods: </strong>We describe an observational series of 12 patients comprising 14 nodules where cryobiopsy was performed during shape-sensing robot-assisted bronchoscopy cryobiopsy under general anesthesia. 3D fluoroscopy was used to confirm accurate placement of the cryoprobe. All these patients underwent a second spin with the 3D fluoroscopy either to sample a second lesion intraoperatively or to investigate suspected pneumothorax.</p><p><strong>Results: </strong>The development of a pneumatocele was noted after cryobiopsy in each of the cases. The majority of these were in the upper lobe with the median size of a sampled nodule being 14 mm. The majority of patients were asymptomatic with 1 patient developing mild hemoptysis and 4 patients developing chest tightness or dyspnea. None of the patients required an intervention for the pneumatocele.</p><p><strong>Conclusion: </strong>The development of pneumatoceles appears to be a fairly frequent and benign occurrence following cryobiopsy, likely due to increased tissue destruction. The increased use of intraoperative 3D fluoroscopy is likely to highlight changes to the pulmonary parenchyma that were previously not known. The occurrence of pneumatoceles does not appear to adversely impact the safety or tolerability profile of cryobiopsy.</p>","PeriodicalId":21048,"journal":{"name":"Respiration","volume":" ","pages":"275-279"},"PeriodicalIF":3.5,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140111291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Oleothorax: An Ultrasound Sign of an Old Practice. 腹腔积液,这是一种古老做法的超声波征兆。
IF 3.5 3区 医学
Respiration Pub Date : 2024-01-01 Epub Date: 2024-03-12 DOI: 10.1159/000538276
Krisstopher Richard Flores, Daniel Piamonti, Rossana Vigliarolo, Pietro Impellizzeri, Mattia Serao, Marianna Lilli, Tiziana Trequattrini, Rosario Rivitti, Angela Maria Pia Succu, Giuseppina Gioffrè, Carola Condoluci, Barbara Maggi, Samantha Lamarra, Annalisa Villani, Gian Pietro Marchetti, Maria Cristina Zappa, Paolo Palange
{"title":"Oleothorax: An Ultrasound Sign of an Old Practice.","authors":"Krisstopher Richard Flores, Daniel Piamonti, Rossana Vigliarolo, Pietro Impellizzeri, Mattia Serao, Marianna Lilli, Tiziana Trequattrini, Rosario Rivitti, Angela Maria Pia Succu, Giuseppina Gioffrè, Carola Condoluci, Barbara Maggi, Samantha Lamarra, Annalisa Villani, Gian Pietro Marchetti, Maria Cristina Zappa, Paolo Palange","doi":"10.1159/000538276","DOIUrl":"10.1159/000538276","url":null,"abstract":"<p><strong>Introduction: </strong>The high morbidity and mortality of tuberculosis has led to the development of numerous therapeutic interventions during the pre-antibiotic era. In 1894, Forlanini proposed the technique of collapse therapy, using spontaneous pneumothorax. In 1926, Bernou developed the oleothorax technique to induce an iatrogenic collapse of the lung through the instillation of oil into the pleural cavity, which was subsequently removed. Nowadays, there are few patients that still represent a living testimony of this historic technique and have been described through traditional radiology.</p><p><strong>Case presentation: </strong>We report the case of a patient with evidence of a right oleothorax that was investigated not only with traditional radiology but also with the use of chest ultrasonography. Ultrasounds were able to show peculiar characteristics of the oleothorax, including its particular echogenicity, the rigidity and static nature of the collection, the presence of peripheral calcifications, and the negative impact of the collection on diaphragmatic mobility and excursion.</p><p><strong>Conclusion: </strong>To our knowledge, this is the first report of an ultrasound description of oleothorax. We have observed that ultrasound examination, in cases of basal oleothorax, is able to add information regarding its radiological appearance and physiopathological implications on ventilatory mechanics and diaphragmatic distress.</p>","PeriodicalId":21048,"journal":{"name":"Respiration","volume":" ","pages":"353-358"},"PeriodicalIF":3.5,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140111304","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Transbronchial Cryobiopsy Using the Ultrathin 1.1-mm Cryoprobe with Ultrathin Bronchoscopy under Radial Endobronchial Ultrasound Guidance for Diagnosis of Peripheral Pulmonary Lesions. 在径向支气管内超声引导下,使用 1.1 毫米超薄冷冻探针和超薄支气管镜进行经支气管冷冻生物切片检查,以诊断肺部周围病变。
IF 3.5 3区 医学
Respiration Pub Date : 2024-01-01 Epub Date: 2024-03-12 DOI: 10.1159/000538196
Franziska Hasselbring, Felix J F Herth, Mark Kriegsmann, Katharina Kriegsmann, Ralf Eberhardt
{"title":"Transbronchial Cryobiopsy Using the Ultrathin 1.1-mm Cryoprobe with Ultrathin Bronchoscopy under Radial Endobronchial Ultrasound Guidance for Diagnosis of Peripheral Pulmonary Lesions.","authors":"Franziska Hasselbring, Felix J F Herth, Mark Kriegsmann, Katharina Kriegsmann, Ralf Eberhardt","doi":"10.1159/000538196","DOIUrl":"10.1159/000538196","url":null,"abstract":"<p><strong>Introduction: </strong>Today, the increasing number of incidentally detected peripheral pulmonary lesions (PPLs) within and outside lung cancer screening trials is a diagnostic challenge. This fact encourages further improvement of diagnostic procedures to increase the diagnostic yield of transbronchial biopsy, which has been shown to have a low complication rate. The purpose of this study was to evaluate the safety and feasibility of a new ultrathin 1.1 cryoprobe that can be placed through an ultrathin bronchoscope (UTB) using fluoroscopy and radial endobronchial ultrasonography (rEBUS) navigation for assessing PPLs.</p><p><strong>Methods: </strong>Thirty-five patients with PPL less than 4 cm in diameter were prospectively enrolled to receive transbronchial cryobiopsies (TBCBs) using the ultrathin 1.1-mm cryoprobe. Navigation to the PPL was accomplished with the UTB. Under rEBUS and fluoroscopy guidance up to 4 cryobiopsies were obtained. The sample sizes of the biopsies were compared to a historic collective derived from a 1.9-mm cryoprobe and standard forceps. The feasibility and safety of the procedure, the cumulative and overall diagnostic yield, and the cryobiopsy sizes were evaluated.</p><p><strong>Results: </strong>After detection with the rEBUS, TBCB was collected from 35 PPLs, establishing a diagnosis in 25 cases, corresponding to an overall diagnostic yield of 71.4%. There was no difference in diagnostic yield for PPL &lt;20 mm or ≥20 mm. All cryobiopsies were representative with a mean tissue area of 11.9 ± 4.3 mm2, which was significantly larger compared to the historic collective (p = 0.003). Six mild and four moderate bleeding events and 1 case of pneumothorax were observed.</p><p><strong>Conclusions: </strong>Using the ultrathin 1.1-mm cryoprobe combined with an UTB for rEBUS-guided TBCB of PPL is feasible and safe. This diagnostic approach improves bronchoscopic techniques for diagnosing peripheral lung lesions and may contribute to improve diagnosis of lung cancer even in small PPL.</p>","PeriodicalId":21048,"journal":{"name":"Respiration","volume":" ","pages":"268-274"},"PeriodicalIF":3.5,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140111306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Diagnostic Yield and Safety of the 19-Gauge versus 22-Gauge Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration Needle in Subjects with Sarcoidosis (GUESS). 肉样瘤患者使用 19 号 EBUS-TBNA 针与 22 号 EBUS-TBNA 针的诊断率和安全性(GUESS)。
IF 3.5 3区 医学
Respiration Pub Date : 2024-01-01 Epub Date: 2024-03-26 DOI: 10.1159/000538121
Sahajal Dhooria, Inderpaul Singh Sehgal, Kuruswamy Thurai Prasad, Valliappan Muthu, Pooja Dogra, Mandeep Saini, Nalini Gupta, Amanjit Bal, Ashutosh Nath Aggarwal, Ritesh Agarwal
{"title":"Diagnostic Yield and Safety of the 19-Gauge versus 22-Gauge Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration Needle in Subjects with Sarcoidosis (GUESS).","authors":"Sahajal Dhooria, Inderpaul Singh Sehgal, Kuruswamy Thurai Prasad, Valliappan Muthu, Pooja Dogra, Mandeep Saini, Nalini Gupta, Amanjit Bal, Ashutosh Nath Aggarwal, Ritesh Agarwal","doi":"10.1159/000538121","DOIUrl":"10.1159/000538121","url":null,"abstract":"<p><strong>Introduction: </strong>Observational data suggest that the 19-gauge (G) needle for endobronchial ultrasound (EBUS)-guided transbronchial needle aspiration (TBNA) offers a higher diagnostic yield than the 22-G needle in sarcoidosis. No randomized trial has compared the yield of the two needles.</p><p><strong>Methods: </strong>We randomized consecutive subjects with suspected sarcoidosis and enlarged thoracic lymph nodes to undergo EBUS-TBNA with either the 19-G or the 22-G needle. We compared the study groups for diagnostic sensitivity (primary outcome) assessed by the yield of granulomas in subjects finally diagnosed with sarcoidosis. We also compared the sample adequacy, difficulty performing the needle puncture assessed on a visual analog scale (VAS), the subject's cough intensity on an operator-rated VAS, and procedure-related complications (secondary outcomes).</p><p><strong>Results: </strong>We randomized 150 (mean age, 43.0 years; 55% women) subjects and diagnosed sarcoidosis in 116 subjects. The diagnostic sensitivity of the 19-G needle (45/60, 75.0%) was not higher (p = 0.52) than the 22-G needle (39/56, 69.6%). We obtained adequate aspirates in 90.0% and 85.7% of subjects in the respective groups (p = 0.48). The operators had greater difficulty puncturing lymph nodes with the 19-G needle (p = 0.03), while the operator-assessed cough intensity was similar in the groups (p = 0.41). Transient hypoxemia was the only complication encountered during EBUS-TBNA (two subjects in either group).</p><p><strong>Conclusion: </strong>We did not find the 19-G needle superior to the 22-G in diagnostic sensitivity, specimen adequacy, or safety of EBUS-TBNA in sarcoidosis. Puncturing the lymph nodes was more difficult with the 19-G needle.</p>","PeriodicalId":21048,"journal":{"name":"Respiration","volume":" ","pages":"336-343"},"PeriodicalIF":3.5,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140294377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
An International Survey of Practices in the Investigation and Endoscopic Treatment of Peripheral Pulmonary Lesions amongst Interventional Bronchoscopists. 关于介入性支气管镜医师对周围肺部病变的调查和内窥镜治疗方法的国际调查。
IF 3.5 3区 医学
Respiration Pub Date : 2024-01-01 Epub Date: 2024-02-23 DOI: 10.1159/000536271
Thibaud Soumagne, Hervé Dutau, Georgie Eapen, Nicolas Guibert, Christopher Hergott, Fabien Maldonado, Hideo Saka, Marc Fortin
{"title":"An International Survey of Practices in the Investigation and Endoscopic Treatment of Peripheral Pulmonary Lesions amongst Interventional Bronchoscopists.","authors":"Thibaud Soumagne, Hervé Dutau, Georgie Eapen, Nicolas Guibert, Christopher Hergott, Fabien Maldonado, Hideo Saka, Marc Fortin","doi":"10.1159/000536271","DOIUrl":"10.1159/000536271","url":null,"abstract":"<p><strong>Introduction: </strong>The investigation of peripheral pulmonary lesions (PPLs) can be challenging. Several bronchoscopic modalities have been developed to reach and biopsy PPL but the level of adoption of these techniques by interventional pulmonologists (IPs) is unknown. This international survey was conducted to describe current practices in PPL investigation among IP.</p><p><strong>Methods: </strong>This survey was sent to all members of the World Association for Bronchology and Interventional Pulmonology, Canadian Thoracic Society Procedures Assembly, AABIP, and the Groupe d'Endoscopie Thoracique et Interventionnel Francophone. The survey was composed of 48 questions and three clinical cases to establish a portrait of modalities used to investigate and treat PPL by IP around the world.</p><p><strong>Results: </strong>Three hundred and twelve IP responded to the survey. Most of them practice in Europe (n = 122), North America (n = 97), and Asia (n = 49). Half of responders perform more than 100 endoscopic procedures for PPL annually. General anesthesia and conscious sedation are used in similar proportions (53% and 47%, respectively). Rapid on site evaluation (ROSE) is used when sampling PPL by 42%. Radial EBUS (69%), fluoroscopy (55%), and electromagnetic navigation (27%) are the most widely used techniques. Most IP combine techniques (89%). Robotic bronchoscopy (15%) and cone-beam CT (8%) are almost exclusively used in the USA where, respectively, 60% and 37% of respondents reported using these modalities. Ten percent of IP currently had access to endoscopic treatment modalities for PPL. However, half of the remaining IP plan to acquire an endoscopic treatment modality in the next 2 years.</p><p><strong>Conclusion: </strong>Available techniques and practices worldwide vary significantly regarding PPL investigation and treatment.</p>","PeriodicalId":21048,"journal":{"name":"Respiration","volume":" ","pages":"146-154"},"PeriodicalIF":3.5,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139973311","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Oscillometry in Chronic Cough: Data from a General Population Cohort. 慢性咳嗽中的振荡测量:来自普通人群队列的数据。
IF 3.5 3区 医学
Respiration Pub Date : 2024-01-01 Epub Date: 2024-06-03 DOI: 10.1159/000539327
Hazim Abozid, Emiel F M Wouters, Marie-Kathrin Breyer
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