title: Latest advances in advanced diagnostic and therapeutic pulmonary procedures.
abstract: Over the past 15 years, patients with a myriad of pulmonary conditions have been diagnosed and treated with new technologies developed for the pulmonary community. Advanced diagnostic and therapeutic procedures once performed in an operating theater under general anesthesia are now routinely performed in a bronchoscopy suite under moderate sedation with clinically meaningful improvements in outcome. With the miniaturization of scopes and instruments, improvements in optics, and creative engineers, a host of new devices has become available for clinical testing and use. A growing community of pulmonologists is doing comparative effectiveness trials that test new technologies against the current standard of care. While more research is needed, it seems reasonable to provide an overview of pulmonary procedures that are in various stages of development, testing, and practice at this time. Five areas are covered: navigational bronchoscopy, endobronchial ultrasound, endoscopic lung volume reduction, bronchial thermoplasty, and pleural procedure. Appropriate training for clinicians who wish to provide these services will become an area of intense scrutiny as new skills will need to be acquired to ensure patient safety and a good clinical result.
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Medical University of South Carolina, Charleston, SC. Electronic address: silvestri@musc.edu.
authors.forename: Gerard A
authors.initials: GA
authors.lastname: Silvestri
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, MD.
authors.forename: David
authors.initials: D
authors.lastname: Feller-Kopman
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Washington University School of Medicine/Barnes-Jewish Hospital, St. Louis, MO.
authors.forename: Alexander
authors.initials: A
authors.lastname: Chen
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Duke University, Durham, NC.
authors.forename: Momen
authors.initials: M
authors.lastname: Wahidi
authors.affiliation: Division of Thoracic Surgery, Toronto General Hospital, University Health Network, University of Toronto, Toronto, ON, Canada.
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Yasufuku
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Steward St. Elizabeth's Medical Center, Tufts Medical School, Boston, MA.
authors.forename: Armin
authors.initials: A
authors.lastname: Ernst
mesh_terms: D001999:Bronchoscopy / Q000639:trends*; D004724:Endoscopy / Q000639:trends; D006801:Humans; D008171:Lung Diseases / Q000175:diagnosis* / Q000628:therapy*; D011013:Pneumonectomy / Q000639:trends; D014463:Ultrasonography / Q000639:trends*