Diagnosis of Lung Lesions by Endobronchial Ultrasound With an Alternative Guide Sheath
Diagnosis of Lung Lesions by Endobronchial Ultrasound With an Alternative Guide Sheath
The purpose of this study is to examine the usefulness of a balloon covered sheath as a guide
 sheath in endobronchial ultrasound guided transbronchial biopsy and bronchial brushing
 cytology for diagnosis of peripheral lung lesions
Flexible bronchoscopy has been applied in the diagnosis of peripheral pulmonary lesions
 (PPLs) for decades. Without accurate localization, the diagnostic yield for peripheral lung
 cancers by these procedures is limited and variable. Localization of peripheral lung cancers
 can be aided by the use of computed tomography or fluoroscopy during fiberoptic bronchoscopy.
 However, radiation exposure to staffs and patients is always a concern in these procedures.

 The clinical application of endobronchial ultrasound (EBUS) included determination of the
 depth of tumor invasion in tracheobronchial wall, evaluation of tracheobronchial structure
 before therapeutic bronchoscopy, localization of site of biopsy, EBUS-guided transbronchial
 needle aspiration, and analysis of peripheral tumor. Under EBUS guidance, the diagnostic
 yield of transbronchial lung biopsy in patients with peripheral lung cancer by bronchoscopic
 examination was significantly improved without an increase in the complication rate. More
 recently, with the aid of a guide sheath (EBUS-GS), EBUS has been shown to increase the
 diagnostic yield of PPLs, even in patients with fluoroscopy-invisible lung nodules, and avert
 the need for surgical procedures.

 Most recently used GS for EBUS are specified for the EBUS probe with an external diameter of
 1.9 mm. Such a thin caliber GS is designed to reach the PPLs, sometimes with an aid of
 curette, to provide an exact site for repeated obtainment of adequate specimens. We wonder
 whether a larger caliber sheath transformed from a balloon covered with an external diameter
 of 2.6 mm without reaching the PPLs, can offer similar effectiveness in diagnosis of the
 PPLs. The results may provide an alternative way for EBUS-GS especially in those countries
 where the commonly used GS of EBUS is not available.
Inclusion Criteria:

 -  patients with peripheral pulmonary lesions who are going to receive bronchoscopy

 Exclusion Criteria:

 -  endobronchial abnormalities

 -  associated lung parenchyma changes, ex. lung collapse or atelectasis