Impact of Flexible Bronchoscopy Procedure on Diagnostic Yield of Peripheral Lung Lesions

Abstract

Background. Transbronchial biopsy (TBB) and brushing by flexible bronchoscopy are useful diagnostic tools, and are both recommended to improve the diagnostic yield of peripheral lung lesions. However, sometimes these procedures cannot be performed because of their adverse effects. Purpose. In the present study, we investigated whether the choice of the first procedure may influence diagnostic yield and adverse effects. Methods. The subjects included those who underwent pulmonary surgical resection and were diagnosed with lung cancer at Kishiwada City Hospital from October 2009 to September 2012. The subjects were divided into two groups according to the preceding procedure: biopsy or brushing. We compared the diagnostic yield and adverse effects between the two groups. Results. There were 116 patients in the final analysis (33 patients in the TBB group and 83 patients in the brushing group). There were no significant differences of the baseline characteristics between the two groups. In the TBB group, the diagnostic yield was significantly higher, and bleeding events were lower than those in the brushing group (54.5% vs 31.3%, p=0.002 and 30.0% vs 66.3%, p=0.001, respectively). Conclusion. The diagnostic yield of peripheral lung lesions may be improved by performing TBB before brushing using flexible bronchoscopy.