Ability and limitations of endobronchial ultrasonography to diagnose peripheral pulmonary lesions

Abstract

Study objective: To assess the ability of endobronchial ultrasonography (EUS) using a guide sheath (EBUS-GS) to diagnose peripheralpulmonary lesions. Method. We devised a technique for EBUS-GS covering a miniature probe, and 183 lesions were evaluated. in this procedure, the probe covered by a guide sheath is introduced into the lesion via the working channel of a bronchoscope. The probe is withdrawn, a brush or biopsy forceps is introduced through the guide sheath into the lesion. Results. 183 of 152 EBUS-GS procedures (83 %) were diagnostic. When using cytological brushes in 45.9 % of cases (84 of 183), with transbronchial biopsy in 81.4 % (149 of 183 cases) [p < 0.001, х2]. The diagnostic yield from EBUS-GS in lesions > 30 mm (27 of 29 lesions, 93.1 %) had a significantly higher diagnostic yield than in lesions < 10 mm (18 of 32 lesions, 56.25 %), [р < 0,001, х2]. in case of 10-20 mm lesions and 20-30 mm [р = 0,87, х2] ones, they were similar. Cases in which the lesion was located in S8 right lung, had a significantly higher diagnostic yield (14 of 14 lesions, 100 %), than when the lesion was located S1-2 left lung (8 of 28 cases, 28.5 %) [р < 0.01, X²]. Moderate bleeding occurred in two patients (2.2 %); pneumothorax in one case (0.5 %), no other complications. Conclusions. EBUS-GS is a effective method for collecting samples from peripheral pulmonary lesions, have the advantage in comparison with another technique.