The Effect of General Anesthesia Versus Intravenous Sedation on Diagnostic Yield and Success in Electromagnetic Navigation Bronchoscopy
The Effect of General Anesthesia Versus Intravenous Sedation on Diagnostic Yield and Success in Electromagnetic Navigation Bronchoscopy
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DOI：
10.1097/lbr.0000000000000120
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发表时间：
2015-01-01
影响因子：
3.3
通讯作者：
Ben, Sharon
中科院分区：
文献类型：
--
作者：
Bowling, Mark R.;Kohan, Matthew W.;Ben, Sharon
背景资料：导航支气管镜用于引导周围肺结节的活检，并放置基准标记物，用于立体定向体部放疗治疗局限期肺癌。用于这种手术的镇静剂类型仍然存在争议。我们进行了回顾性图表审查，以评估诊断率和整体成功的程序的基础上麻醉type.Methods的差异：电磁导航支气管镜检查进行了使用superDimension软件系统。一旦靶病变在可及范围内，就获得多个组织样本。统计分析用于将产率与镇静类型以及其他因素相关联。一个成功的程序定义，如果诊断或基准标记是充分placed.Results：导航支气管镜进行了总共120个目标病变。手术的总体并发症发生率为4.1%。诊断率和手术成功率分别为74%和87%。手术持续时间是全身麻醉组和IV镇静组之间唯一的显著差异（平均值，58 vs. 43 min，P = 0.0005）。肿瘤大小越大，诊断率越高（P = 0.032）。所有其他变量的诊断率和一个不成功的程序方面的影响没有达到统计学意义。结论：导航支气管镜检查是一种安全有效的肺部诊断工具，并发症发生率相对较低。诊断率和手术的总体成功率似乎不受所用镇静剂类型的影响。
Background: Navigational bronchoscopy is utilized to guide biopsies of peripheral lung nodules and place fiducial markers for treatment of limited stage lung cancer with stereotactic body radiotherapy. The type of sedation used for this procedure remains controversial. We performed a retrospective chart review to evaluate the differences of diagnostic yield and overall success of the procedure based on anesthesia type.Methods: Electromagnetic navigational bronchoscopy was performed using the superDimension software system. Once the targeted lesion was within reach, multiple tissue samples were obtained. Statistical analysis was used to correlate the yield with the type of sedation among other factors. A successful procedure was defined if a diagnosis was made or a fiducial marker was adequately placed.Results: Navigational bronchoscopy was performed on a total of 120 targeted lesions. The overall complication rate of the procedure was 4.1%. The diagnostic yield and success of the procedure was 74% and 87%, respectively. Duration of the procedure was the only significant difference between the general anesthesia and IV sedation groups (mean, 58 vs. 43 min, P = 0.0005). A larger tumor size was associated with a higher diagnostic yield (P = 0.032). All other variables in terms of effect on diagnostic yield and an unsuccessful procedure did not meet statistical significance.Conclusions: Navigational bronchoscopy is a safe and effective pulmonary diagnostic tool with relatively low complication rate. The diagnostic yield and overall success of the procedure does not seem to be affected by the type of sedation used.