title: A new middle-range diameter bronchoscope with large channel for transbronchial sampling of peripheral pulmonary lesions.
abstract: OBJECTIVE
  Although the diagnostic yield of guided bronchoscopy for peripheral pulmonary lesions has improved to 70%, it is still low compared with transthoracic needle aspiration. We produced a new bronchoscope with middle-range diameter and large channel (BF-Y0053, Olympus, Japan), and evaluated its diagnostic efficacy for peripheral pulmonary lesions.
  
  
  METHODS
  This was a retrospective study on 70 consecutive patients with peripheral pulmonary lesions who underwent diagnostic bronchoscopy using BF-Y0053 combined with endobronchial ultrasound with a guide sheath at the National Cancer Center Hospital from September 2013 to November 2013. Diagnostic performance of the procedure was analyzed and compared among three groups of peripheral pulmonary lesions: 'peripheral-small' lesions (≤ 30 mm and adjacent to visceral pleura), 'central-small' lesions (≤ 30 mm and not adjacent to the visceral pleura), and 'large' lesions (>30 mm).
  
  
  RESULTS
  Sixty (85.7%) patients had malignant diseases. Diagnosis was established by bronchoscopy in 61 of 70 patients (87.1%); the respective yields for 'central-small' and 'large' lesions were significantly higher than that for 'peripheral-small' lesions (96.3%, 94.4%, 72%, P = 0.0026). This diagnostic accuracy was achieved regardless of other clinical and procedural factors such as, lesion size, feature ground glass opacity (or solid), endobronchial ultrasound-probe location (within or outside) or operator skill. There were no major post-procedural complications.
  
  
  CONCLUSIONS
  A new middle-range diameter bronchoscope with large channel combined with endobronchial ultrasound with a guide sheath can enhance the efficacy of transbronchial sampling to its maximal potential to diagnose peripheral pulmonary lesions safely and accurately, particularly for patients who have tumors away from the visceral pleura.
authors.affiliation: Department of Endoscopy, Respiratory Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan sasastaf@hotmail.co.jp.
authors.forename: Shinji
authors.initials: S
authors.lastname: Sasada
authors.affiliation: Department of Endoscopy, Respiratory Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan.
authors.forename: Takehiro
authors.initials: T
authors.lastname: Izumo
authors.affiliation: Department of Endoscopy, Respiratory Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan.
authors.forename: Christine
authors.initials: C
authors.lastname: Chavez
authors.affiliation: Department of Endoscopy, Respiratory Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Matsumoto
authors.affiliation: Department of Endoscopy, Respiratory Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan.
authors.forename: Takaaki
authors.initials: T
authors.lastname: Tsuchida
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D020680:Bronchoscopes; D001999:Bronchoscopy / Q000295:instrumentation*; D003937:Diagnosis, Differential; D061765:Endoscopic Ultrasound-Guided Fine Needle Aspiration; D019160:Endosonography; D004867:Equipment Design; D006801:Humans; D007564:Japan; D008168:Lung / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D008171:Lung Diseases / Q000175:diagnosis; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies
keywords: endobronchial ultrasonography with a guide sheath; middle-range diameter bronchoscope with large channel; peripheral pulmonary lesions; transbronchial biopsy