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BackgroundVarious modalities of guided bronchoscopy have been developed to improve the diagnostic yield of peripheral pulmonary nodule (PPN). The present study compared the diagnostic yield between thin bronchoscopy (TB) and electromagnetic navigation bronchoscopy (ENB) in diagnosis of PPN.MethodsThe patients with PPN less than or equal to 30 mm were randomly assigned into 2 groups, 4-mm thin bronchoscope (TB group) and 5.9-mm conventional bronchoscope with using ENB (the superDimension) system (ENB group). In both groups, we used radial probe endobronchial ultrasound (R-EBUS) and fluoroscopy to guide transbronchial lung biopsy.ResultsThe total of 49 patients were enrolled and randomized into TB group (n=24) and ENB group (n=25). Mean size of PPN was 22 mm. There was no difference in nodule size, location of nodule, the presence of CT bronchus sign and EBUS visualization between groups. The diagnostic yields were 73.9% and 66.7% in TB group and ENB group, respectively. There was no statistically significant difference in the diagnostic yield between two groups and the non-inferiority of the TB group could not be confirmed. Multivariate analysis showed that the diagnostic yield was significantly higher if there is CT bronchus sign (odd ratio 48.82, p = 0.031) and the bronchoscope can reach more airway depth (odd ratio 6.21, p = 0.023). The overall complication was 2% which is pneumothorax in one patient in the TB group.ConclusionsThe thin bronchoscopy has a comparable diagnostic yield as electromagnetic bronchoscopy in diagnosis of peripheral pulmonary nodule without serious complication.Trial registrationTCTR, TCTR20200224003. Registered 24 February 2020 - Retrospectively registered, https://www.clinicaltrials.in.th/index.php?tp=regtrials&menu=trialsearch&smenu=fulltext&task=search&task2=view1&id=5834. |
