Navigation Links
Combination of Bronchoscopic Techniques is Very Effective for Lung Lesions

A new study shows that the combined use of two minimally invasive techniquesendobronchial ultrasound (EBUS) and electromagnetic navigation bronchoscopy (ENB)-- in the diagnosis of peripheral lung lesions has been shown to be more effective than either procedure alone and does not compromise patients safety.

Multimodality diagnosis with the joint use of EBUS with ENB has pushed the diagnostic yield of flexible bronchoscopic procedures closer to the sensitivity obtainable through either transthoracic CT-guided or surgical biopsies, noted Armin Ernst, M.D., of Harvard Medical School, who wrote the article with colleagues at the University of Heidelberg, Germany.

The ultimate goal of reliable and minimally invasive biopsy of peripheral lung lesions new appears feasible.

The results of the prospective, randomized and multicenter trial were reported in the first issue for July 2007 of the American Journal of Respiratory and Critical Care Medicine, published by the American Thoracic Society.

The study recruited 120 patients with evidence of peripheral lung lesions or solitary pulmonary lesions on prior CT scans who were randomly assigned to undergo bronchoscopic diagnosis by one of three techniques: EBUS alone, ENB alone, or ENB and EBUS in combination.

The diagnostic yieldthe percentage of correct diagnosesof each was then analyzed. If these minimally invasive techniques proved inconclusive, a surgical biopsy, the gold-standard for diagnosis, was performed.

The design of the study deserves comment and compliment, wrote Gerard Silvestri, M.D., M.S., in an accompanying editorial. Rarely do we see a prospective, multicenter trial in the field of interventional pulmonology. Rarer still are subjects randomized to different treatment strategies.

EBUS and ENB represent newer technologies that are growing in use. EBUS allows for direct visualization of lesions, but lacks a navigati on system and requires the operator to maneuver based on prior radiological investigations, such as CT scans. ENB, on the other hand, has a highly specialized real-time navigation system, but lacks a means of directly visualizing the lesion.

The researchers found that the EBUS procedure by itself had a diagnostic yield of 69 percent. ENB alone had a diagnostic yield of 59 percent. But the combination of the two increased the diagnostic yield to 88 percent, independent of lesion sizea highly significant improvement.

In addition, the researchers noted a trend toward improved sensitivity in detecting benign diseases, though it was not statistically significant.

The safety of the combined procedures was assessed by tracking of complications. One of the primary negative outcomes in bronchoscopy is pneumothorax. In this study, the rate of pneumothorax using either ENB or EBUS alone was 5 percent, and in the combined procedures it was 8 percenta statistically insignificant difference.

Another concern was that the extended sedation or anesthesia required in the combined procedure may increase adverse effects due to prolonged sedation or anesthesia, but none was documented.

In his editorial, Dr. Silvestri notes that this study would most likely benefit patients who were too sick to undergo a surgical biopsy but would benefit from chemotherapy if cancer was confirmed through this combined, minimally invasive technique.


'"/>




Related medicine news :

1. Consensus on "Combination Therapy" for Breast Cancer
2. Drug Combinations May Boost Stroke Risk
3. Combination therapy to treat breast cancer
4. Combination regime may work against prostate cancer
5. Smoking and Breast Cancer - A Deadly Combination
6. New Drug Combination Found To Improve Memory in Alzheimer’s Patient
7. A Combination Of Drugs Effective In The Treatment Of Hormone-Refractory Prostate Cancer
8. Combination Therapy Effective In Improving Lung Cancer Survival
9. Combination Therapy Found To Improves Stroke Recovery
10. Combination Therapy Found To Be More Effective In Treating Brain Cancer
11. Combination of Clopidogrel-aspirin is better for preventing stroke than only aspirin
Post Your Comments:
*Name:
*Comment:
*Email:


(Date:6/24/2016)... , ... June 24, 2016 , ... Marcy was in a crisis. Her son James, ... out at his family verbally and physically. , “When something upset him, he couldn’t control ... use it. He would throw rocks at my other children and say he was going ...
(Date:6/24/2016)... ... 2016 , ... Topical BioMedics, Inc, makers of Topricin and MyPainAway Pain Relief Products, join The ... raise to $12 an hour by 2020 and then adjusting it yearly to increase at ... the minimum wage, assure the wage floor does not erode again, and make future increases ...
(Date:6/24/2016)... ... June 24, 2016 , ... Strategic ... Frederick area economy by obtaining investment capital for emerging technology companies. SCP ... that have already resulted in more than a million dollars of capital investment ...
(Date:6/24/2016)... ... ... Finally, a bruise cream that really works. Originally designed to reduce ... post-surgical treatment plans of a variety of other procedures including, but not limited to, ... bruising and causes a rapid resolution of bruising and inflammatory changes compared to no ...
(Date:6/24/2016)... , ... June 24, 2016 , ... Dr. Seema Daulat, ... Evans Dermatology in the South Lamar location as of July 13, 2016. , Dr. ... School. As a medical student, she regularly volunteered at the Agape Clinic serving Dallas’ ...
Breaking Medicine News(10 mins):
(Date:6/24/2016)... , June 24, 2016 The Academy of ... recommendations that would allow biopharmaceutical companies to ... entities that make formulary and coverage decisions, a move ... of new medicines. The recommendations address restrictions ... appear on the drug label, a prohibition that hinders ...
(Date:6/24/2016)... India , June 24, 2016 ... Needles Market by Type (Standard Pen Needles, Safety Pen ... Therapy (Insulin, GLP-1, Growth Hormone), Mode of Purchase (Retail, ... by MarketsandMarkets, This report studies the market for the ... expected to reach USD 2.81 Billion by 2021 from ...
(Date:6/23/2016)... , June 23, 2016  MedSource announced ... as its e-clinical software solution of choice.  This ... best possible value to their clients by offering ... The preferred relationship establishes nowEDC as the EDC ... for MedSource,s full-service clients.  "nowEDC has long been ...
Breaking Medicine Technology: