title: Diagnostic yield of flexible bronchoscopy without fluoroscopic guidance in evaluating peripheral lung lesions.
abstract: OBJECTIVE
  Flexible bronchoscopy (FB) is frequently performed in patients with peripheral lung lesions. The aim of this study was to evaluate the diagnostic yield, factors affecting diagnostic yield, complications, and safety of FB without fluoroscopic guidance in patients with peripheral lung lesions.
  
  
  METHODS
  We retrospectively reviewed the medical records of all patients who underwent FB without fluoroscopic guidance for the diagnosis of peripheral lung lesions between 1999 and 2004.
  
  
  RESULTS
  Ninety-three patients were enrolled. Among these, 38 lesions were malignant, 46 were benign, and 9 were indeterminate. The overall diagnostic rate was 65%, and the diagnostic sensitivities for malignant and benign lesions were 68% and 74%, respectively. The diagnostic yield was significantly higher for lesions >2 cm (70%) than for lesions ≤2 cm (11%; P <0.001). The diagnostic yield of transbronchial lung biopsy (46%) was higher than that of bronchial washing (29%; P=0.025) or brushing (29%; P=0.022). The yield of transbronchial lung biopsy for malignant disease (70%) was higher than that of benign disease (35%; P=0.003). Pneumothoraces and significant bleeding developed in 4.3% and 2.2% of patients, respectively.
  
  
  CONCLUSIONS
  This study showed that FB sampling without fluoroscopic guidance was safe with a high rate of accuracy for the diagnosis of lung lesions not visible through a bronchoscope. When we performed a computed tomography scan and determined the exact location of the lesion before FB, the diagnostic yield of FB without fluoroscopic guidance was comparable with that reported earlier using fluoroscopy.
authors.affiliation: Division of Pulmonary, Critical Care and Sleep Medicine, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Chin Kook
authors.initials: CK
authors.lastname: Rhee
authors.forename: Hyun Hui
authors.initials: HH
authors.lastname: Kang
authors.forename: Ji Young
authors.initials: JY
authors.lastname: Kang
authors.forename: Jin Woo
authors.initials: JW
authors.lastname: Kim
authors.forename: Yong Hyun
authors.initials: YH
authors.lastname: Kim
authors.forename: Shin Ae
authors.initials: SA
authors.lastname: Park
authors.forename: Hwa Sik
authors.initials: HS
authors.lastname: Moon
authors.forename: Sang Haak
authors.initials: SH
authors.lastname: Lee