Factors Related to Diagnostic Yield of Flexible Bronchoscopy Without Guidance in Bronchoscopically Invisible Peripheral Lung Lesions

Factors Related to Diagnostic Yield of Flexible Bronchoscopy Without Guidance in Bronchoscopically Invisible Peripheral Lung Lesions

Procedures SESSION TITLE: Procedures 1 - EMN/BT/Rigid/Cryo SESSION TYPE: Original Investigation Poster PRESENTED ON: Wednesday, October 26, 2016 at 01...

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Procedures SESSION TITLE: Procedures 1 - EMN/BT/Rigid/Cryo SESSION TYPE: Original Investigation Poster PRESENTED ON: Wednesday, October 26, 2016 at 01:30 PM - 02:30 PM

Factors Related to Diagnostic Yield of Flexible Bronchoscopy Without Guidance in Bronchoscopically Invisible Peripheral Lung Lesions Jongmin Lee MD* Hye Seon Kang MD Wooho Ban MD Sung Bae Cho Myung Sook Kim Young Soo Lee; and Sang Lee MD St. Paul’s Hospital, The Catholic University of Korea, Seoul, Korea (the Republic of) PURPOSE: The purpose of this study was to evaluate factors predicting the diagnostic yield of flexible bronchoscopy without guidance in peripheral lung lesions invisible endoscopically. METHODS: The medical records of 204 patients who had underwent flexible bronchoscopy for the evaluation of peripheral lesions without endobronchial lesions were reviewed retrospectively. The analyzed variables included the etiology of lesion, lesion size, distance from pleura, and the presence of bronchus sign. We performed a multivariate analysis of the predictive factors of the diagnosis using the logistic regression technique. RESULTS: One hundred fifty-one patients were included in the study, with a mean age of 65  14 years. The overall diagnostic yield was 58.3%. Sensitivity was 43.2% in malignant disease and 78.1% in benign disease. The etiology of lung lesion (P ¼ < 0.001), lesion size (P ¼ 0.018) and the presence of bronchus sign (P < 0.001) were factors influencing the yield of flexible bronchoscopy by univariate analysis. In multivariate logistic regression analysis, the exposed type of bronchus sign and benign lung lesions were determinant factors (OR 22.4, 95% CI 6.5-77.7, P < 0.001; OR 6.4, 95% CI 2.5-16.1, P < 0.001). CONCLUSIONS: The presence of the exposed type of bronchus sign and the benign lung lesions are determinants of diagnostic yield in flexible bronchoscopy when evaluating peripheral lesions not visible endoscopically. CLINICAL IMPLICATIONS: Conventional flexible bronchoscopy can be a useful tool to diganose peripheral lung lesions that show exposed type of bronchus sign, even without fluoroscopic guidance. DISCLOSURE: The following authors have nothing to disclose: Jongmin Lee, Hye Seon Kang, Wooho Ban, Sung Bae Cho, Myung Sook Kim, Young Soo Lee, Sang Lee

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http://dx.doi.org/10.1016/j.chest.2016.08.1118

Copyright ª 2016 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

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