Shape-sensing robotic-assisted bronchoscopy for pulmonary nodules: initial multicenter experience using the Ion™ Endoluminal System.

Autor: Simoff MJ; Bronchoscopy and Interventional Pulmonology, Lung Cancer Screening Program, Department of Pulmonary and Critical Care Medicine, Henry Ford Hospital, Wayne State University School of Medicine, 2799 West Grand Blvd, Detroit, MI, 48202, USA. MSimoff1@hfhs.org., Pritchett MA; Pulmonary Department, Pinehurst Medical Clinic, Pinehurst, NC, USA.; Pulmonary Department, First Health Moore Regional Hospital, Pinehurst, NC, USA., Reisenauer JS; Department of Pulmonary Medicine and Thoracic Surgery, Mayo Clinic, Rochester, MN, USA., Ost DE; Department of Pulmonary Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA., Majid A; Department of Thoracic Surgery and Interventional Pulmonology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA., Keyes C; Department of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA., Casal RF; Department of Pulmonary Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA., Parikh MS; Department of Thoracic Surgery and Interventional Pulmonology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA., Diaz-Mendoza J; Bronchoscopy and Interventional Pulmonology, Lung Cancer Screening Program, Department of Pulmonary and Critical Care Medicine, Henry Ford Hospital, Wayne State University School of Medicine, 2799 West Grand Blvd, Detroit, MI, 48202, USA., Fernandez-Bussy S; Department of Pulmonary Medicine, Mayo Clinic, Jacksonville, FL, USA., Folch EE; Department of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Jazyk: angličtina
Zdroj: BMC pulmonary medicine [BMC Pulm Med] 2021 Oct 16; Vol. 21 (1), pp. 322. Date of Electronic Publication: 2021 Oct 16.
DOI: 10.1186/s12890-021-01693-2
Abstrakt: Background: Traditional bronchoscopy provides limited approach to peripheral nodules. Shape-sensing robotic-assisted bronchoscopy (SSRAB, Ion™ Endoluminal System) is a new tool for minimally invasive peripheral nodule biopsy. We sought to answer the research question: Does SSRAB facilitate sampling of pulmonary nodules during bronchoscopists' initial experience?
Methods: The lead-in stage of a multicenter, single-arm, prospective evaluation of the Ion Endoluminal System (PRECIsE) is described. Enrolled subjects ≥ 18 years old had recent computed tomography evidence of one or more solid or semi-solid pulmonary nodules ≥ 1.0 to ≤ 3.5 cm in greatest dimension and in any part of the lung. Subjects were followed at 10- and 30-days post-procedure. This stage provided investigators and staff their first human experience with the SSRAB system; safety and procedure outcomes were analyzed descriptively. Neither diagnostic yield nor sensitivity for malignancy were assessed in this stage. Categorical variables are summarized by percentage; continuous variables are summarized by median/interquartile range (IQR).
Results: Sixty subjects were enrolled across 6 hospitals; 67 nodules were targeted for biopsy. Median axial, coronal and sagittal diameters were < 18 mm with a largest cardinal diameter of 20.0 mm. Most nodules were extraluminal and distance from the outer edge of the nodule to the pleura or nearest fissure was 4.0 mm (IQR: 0.0, 15.0). Median bronchial generation count to the target location was 7.0 (IQR: 6.0, 8.0). Procedure duration (catheter-in to catheter-out) was 66.5 min (IQR: 50.0, 85.5). Distance from the catheter tip to the closest edge of the virtual nodule was 7.0 mm (IQR: 2.0, 12.0). Biopsy completion was 97.0%. No pneumothorax or airway bleeding of any grade was reported.
Conclusions: Bronchoscopists leveraged the Ion SSRAB's functionality to drive the catheter safely in close proximity of the virtual target and to obtain biopsies. This initial, multicenter experience is encouraging, suggesting that SSRAB may play a role in the management of pulmonary nodules. Clinical Trial Registration identifier and date NCT03893539; 28/03/2019.
(© 2021. The Author(s).)
Databáze: MEDLINE
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