Diagnostic Factors of Standard Bronchoscopy for Small (≤15 mm) Peripheral Pulmonary Lesions: A Multivariate Analysis
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概要
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Background The aim of this study was to evaluate the factors contributing to an accurate diagnosis of small (≤15 mm) peripheral pulmonary lesions (PPLs) by standard bronchoscopy and to determine the most suitable technology for such a diagnosis. Objective Bronchoscopy was performed for 115 PPLs (≤15 mm diameter) on chest computed tomography (CT) between August 2003 and December 2006. Methods Univariate and multivariate analyses were conducted retrospectively with the R software. Results The diagnostic yield of the 115 PPLs was 65.2%; the yield was 61.9% and 69.2% for the malignant and benign lesions, respectively. In the univariate analysis, the approach to the lesion contributed the most to successful diagnosis, followed by skill and the use of hemostasis. In the multivariate analysis, the most important factor was approach, followed by lower lobe lesion and the use of hemostasis. Although it was better to use a sedative, operator skill was not a contributing factor. Conclusion The approach to the lesion is the most important factor for a successful diagnosis of PPLs by bronchoscopy. Bronchoscopy is time consuming and painful; therefore, it is very important to establish an accurate diagnosis as soon as possible. Further, endobronchial ultrasonography with a guide sheath (EBUS-GS) and navigation systems are useful tools for the diagnosis of small PPLs.
著者
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Okamoto Norio
Department Of Ophthalmology Ntt West Osaka Hospital
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HIRASHIMA Tomonori
Department of Internal Medicine, Osaka Prefectural Habikino Hospita
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Sasada Shinji
Department Of Thoracic Malignancy Osaka Prefectural Medical Center For Respiratory And Allergic Dise
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Kawahara Kunimitsu
Department Of Clinical Laboratory Osaka National Hospital
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Kawase Ichiro
Department Of Hematology And Rheumatology Tohoku University Graduate School Of Medicine
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Suzuki Hidekazu
Department Of Cellular Biology Research Institute For Radiation Biology And Medicine Hiroshima Unive
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Kobayashi Masashi
Department Of Clinical Pharmacology Toyama Medical & Pharmaceutical University
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Hirashima Tomonori
Department of Thoracic Malignancy, Osaka Prefectural Hospital Organization Osaka Prefectural Medical Center for Respiratory and Allergic Diseases, Japan
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Kawahara Kunimitsu
Department of Pathology, Osaka Prefectural Hospital Organization Osaka Prefectural Medical Center for Respiratory and Allergic Diseases, Japan
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Tamiya Motohiro
Department of Thoracic Malignancy, Osaka Prefectural Hospital Organization Osaka Prefectural Medical Center for Respiratory and Allergic Diseases, Japan
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Uehara Nobuko
Department of Thoracic Malignancy, Osaka Prefectural Hospital Organization Osaka Prefectural Medical Center for Respiratory and Allergic Diseases, Japan
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Morishita Naoko
Department of Thoracic Malignancy, Osaka Prefectural Hospital Organization Osaka Prefectural Medical Center for Respiratory and Allergic Diseases, Japan
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Kawase Ichiro
Department of Thoracic Malignancy, Osaka Prefectural Hospital Organization Osaka Prefectural Medical Center for Respiratory and Allergic Diseases, Japan
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Okamoto Norio
Department of Thoracic Malignancy, Osaka Prefectural Hospital Organization Osaka Prefectural Medical Center for Respiratory and Allergic Diseases, Japan
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