The Diagnostic Yield of Navigational Bronchoscopy Performed with Propofol Deep Sedation. (27th May 2013)

• Record Type: Journal Article
• Authors: Mohanasundaram, Uma; Ho, Lawrence A.; Kuschner, Ware G.; Chitkara, Rajinder K.; Canfield, James; Canfield, Lourdes M.; Krishna, Ganesh
• Other Names: Braden B. Academic Editor.; Stoyanov D. Academic Editor.
• Is Part Of: ISRN endoscopy. Volume 2013(2013)
• Publication Date: 2013-05-27
• Subjects: Endoscopy -- Periodicals; 616.07545
• DOI: 10.5402/2013/824693
• Languages: English
• ISSNs: 2090-9411

Abstract

Abstract : Objective . To describe the diagnostic yield of electromagnetic navigation bronchoscopy (ENB) utilizing propofol for procedural deep sedation. Methods . We conducted a structured retrospective analysis of the medical records of patients who underwent ENB with propofol for the evaluation of pulmonary nodules and masses. We analyzed the relationships between lesion size and location, variance (CT-to-body divergence), and positron emission tomography findings on diagnostic yield. Diagnoses were established by histopathological evaluation and clinical-radiographic followup. Results . 41 patients underwent ENB during the study period. The overall diagnostic yield was 89% (42 of 47 target lesions). Among the 42 positive specimens, the diagnoses were squamous cell carcinoma( n = 10 ), adenocarcinoma( n = 14 ), small cell carcinoma( n = 2 ), adenocarcinoma in situ( n = 2 ), coccidioidomycosis( n = 1 ), and inflammatory processes( n = 13 ) . Average lesion size was3.01 ± 0.21 cm and variance3.6 ± 0.15 mm. The diagnostic yield was greater when the lesion size was >4 cm (100%) and when variance was ≤4 mm (91% versus 87%, P = 0.003 ). Conclusion . The diagnostic yield of ENB utilizing propofol for procedural deep sedation at our center was excellent. ENB with deep sedation may result in superior diagnostic yield compared with ENB performed with moderate sedation.