Ability and limitations of endobronchial ultrasonography to diagnose peripheral pulmonary lesions
Study objective: To assess the ability of endobronchial ultrasonography (EUS) using a guide sheath (EBUS-GS) to diagnose peripheral pulmonary lesions. Method: We devised a technique for EBUS-GS covering a miniature probe, and 183 lesions were evaluated. in this procedure, the probe covered by a guide sheath is introduced into the lesion via the working channel of a bronchoscope. The probe is withdrawn, a brush or biopsy forceps is introduced through the guide sheath into the lesion. Results: 183 of 152 EBUS-GS procedures (83%) were diagnostic. When using cytological brushes in 45.9% of cases (84 of 183 cases), with transbronchial biopsy in 81.4% (149 of 183 cases) [p <0.001, х<sup>2</sup>]. The diagnostic yield from EBUS-GS in lesions >30 mm (27 of 29 lesions, 93,1%) had a significantly higher diagnostic yield than in lesions < 10 mm (18 of 32 lesions, 56,25%), [р<0,001,х<sup>2</sup>]. in case of >10 to < 20 mm lesions and >20 to < 30 mm, [р=0,87, х<sup>2</sup>], were similar. Cases in which the lesion was located in S8 right lung, had a significantly higher diagnostic yield (14 of 14 lesions, 100%), than when the lesion was located S1-2 left lung (8 of 28 cases, 28,5%) [р<0,01, х<sup>2</sup>]. Moderate bleeding occurred in two patients (2,2%); pneumothorax in one case (0,5%), no other complications. Conclusions: EBUS-GS is a effective method for collecting samples from peripheral pulmonary lesions, have the advantage in comparison with another technique.