Complications with Endobronchial Ultrasound with a Guide Sheath for the Diagnosis of Peripheral Pulmonary Lesions

Abstract

Background: Diagnostic bronchoscopy has been considered as a safe and effective procedure. Endobronchial ultrasound with a guide sheath (EBUS-GS) for the diagnosis of peripheral pulmonary lesions (PPLs) is becoming a common procedure, but reports about its safety are missing. Objectives: The aim of this study was to evaluate the safety profile of EBUS-GS for the diagnosis of PPLs. Methods: All patients with PPLs who underwent EBUS-GS between September 2012 and August 2014 at the National Cancer Center Hospital were included. Postprocedural complications and the durability of devices were retrospectively reviewed. Results: During the study period, EBUS-GS procedures were performed for 965 PPLs. The overall complication rate was 1.3% (13/965): 0.8% (8/965) for pneumothorax and 0.5% (5/965) for pulmonary infection. There was no significant hemorrhage, air embolism, tumor seeding or procedure-related death, and there was no breakage of the guide sheath. Only four radial probes were broken during the study period without any adverse reactions. Conclusions: EBUS-GS is a tolerable procedure, and the devices are durable.

Hospital Volume and Mortality following Diagnostic Bronchoscopy in Lung Cancer Patients: Data from a National Inpatient Database in Japan

“…However, the average number of EBUS-related procedures in higher-volume hospitals in this study was far from excessive, compared with the findings of previous studies [8, 31]. An observational study of lobectomy from 1999 to 2007 in Canada, where thoracic surgery services have been formally regionalized primarily in high HV centers, found that shifting patients with lung cancer to high-HV centers resulted in improved in-hospital mortality, but there was no reduction in mortality when HV was increased in a given hospital [26].…”

“…Previous studies have shown that hemorrhage, infection, and hypoxia were major complications after DB in patients with lung cancer [7, 8, 28-30]. These complications generally require salvage treatments.…”

“…Consequently, physicians may have been driven to perform DB, which is relatively invasive in bronchoscopic procedures, for patients with advanced lung cancer. New DB techniques, such as methods combined with endobronchial ultrasound (EBUS), have reportedly improved safety [7, 8] as well as the diagnostic yield of bronchoscopic biopsy [9, 10]. Thus, bronchoscopy is generally considered to be a safe examination.…”

Endobronchial ultrasonography with guide sheath versus computed tomography guided transthoracic needle biopsy for peripheral pulmonary lesions: a propensity score matched analysis

“…The following studies reported that the diagnostic yield of EBUS-GS for PPLs was between 57% and 90%, and it was proved to be a safe procedure with low rate of pneumothorax and hemoptysis (6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21). Till now there is only one randomized controlled study (22) comparing the two procedures.…”

The many facets of diagnostic bronchoscopy for pulmonary ground glass nodules

“…Computed tomography (CT)-guided percutaneous biopsy of such lesions had been shown to be accurate (7), but the risk for complications, such as pneumothorax, is not negligible (8). On the other hand, TBB for GGOs has been an emerging modality with good yield and safety profile (9). Several investigators have published their results on the factors that affect the yield of TBB for GGOs (10)(11)(12).…”