Internal Medicine
Online ISSN : 1349-7235
Print ISSN : 0918-2918
ISSN-L : 0918-2918
Diagnostic Factors of Standard Bronchoscopy for Small (≤15 mm) Peripheral Pulmonary Lesions: A Multivariate Analysis
Motohiro TamiyaShinji SasadaMasashi KobayashiNobuko UeharaNorio OkamotoNaoko MorishitaHidekazu SuzukiTomonori HirashimaKunimitsu KawaharaIchiro Kawase
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2011 Volume 50 Issue 6 Pages 557-561


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.

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© 2011 by The Japanese Society of Internal Medicine
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