Ultrathin bronchoscopy

To evaluate the clinical benefits of ultrathin bronchoscope in the pathological diagnosis of peripheral lung lesions, we routinely used a 2.8 mm outer diameter ultrathin for the peripheral lesions with fluoroscopic guidance. A retrospective analysis was performed on the pathological diagnoses, their accuracy, the optimal number of biopsy specimens. In the final diagnoses of 209 malignancies, 132 patients (63%) obtained their results at first examinations. The diagnostic rates were not different as to the size of the tumor of less than 2.0 cm or more. We have tried to obtain 10 biopsy specimens. The diagnostic rate was 46% at the first biopsy, and reached 90% cumulatively on the 6th attempt. In the final diagnoses of benign lesions 39% received pathological diagnosis at the first bronchoscopy. Pneumothorax was experienced in 6 patients (1.5%). All improved by observation only (4) or by tube drainage (2). In 2 patients, ultrathin scope penetrated visceral pleura. No major bleeding was observed. Ultrathin bronchoscopy is a safe and reliable method to obtain the pathological specimen in the diagnosis of peripheral lesions under fluoroscopic guidance. Pneumothorax was the only complication so far. Ultrathin bronchoscopy may be the procedure of choice for peripheral lesions.