title: Diagnostic factors of standard bronchoscopy for small (≤15 mm) peripheral pulmonary lesions: a multivariate analysis.
abstract: 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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Thoracic Malignancy, Osaka Prefectural Hospital Organization, Osaka Prefectural Medical Center for Respiratory and Allergic Diseases, Japan. moto19781205@yahoo.co.jp
authors.forename: Motohiro
authors.initials: M
authors.lastname: Tamiya
authors.forename: Shinji
authors.initials: S
authors.lastname: Sasada
authors.forename: Masashi
authors.initials: M
authors.lastname: Kobayashi
authors.forename: Nobuko
authors.initials: N
authors.lastname: Uehara
authors.forename: Norio
authors.initials: N
authors.lastname: Okamoto
authors.forename: Naoko
authors.initials: N
authors.lastname: Morishita
authors.forename: Hidekazu
authors.initials: H
authors.lastname: Suzuki
authors.forename: Tomonori
authors.initials: T
authors.lastname: Hirashima
authors.forename: Kunimitsu
authors.initials: K
authors.lastname: Kawahara
authors.forename: Ichiro
authors.initials: I
authors.lastname: Kawase
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001984:Bronchial Neoplasms / Q000175:diagnosis / Q000473:pathology; D001999:Bronchoscopy / Q000379:methods* / Q000592:standards / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D055815:Young Adult