Journal of bronchology & interventional pulmonology
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J Bronchology Interv Pulmonol · Jan 2015
Role of ultrasonography in the diagnosis and management of pneumothorax following transbronchial lung biopsy.
Pneumothorax (PTX) following flexible bronchoscopy (FB) and transbronchial lung biopsy (TBLB) occurs in 1% to 6% of cases. Chest radiography (CXR) is therefore routinely requested to detect PTX following TBLB. The objective of this study was to prospectively evaluate the accuracy of ultrasound (US) in the detection of post-TBLB PTX. ⋯ This study demonstrates a good sensitivity of US in detecting PTX following TBBL. Bedside US may become the method of choice for diagnosing, monitoring, and managing PTX after TBLB.
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J Bronchology Interv Pulmonol · Oct 2014
Impact of pleural manometry on the development of chest discomfort during thoracentesis: a symptom-based study.
Routine manometry is recommended to prevent complications during therapeutic thoracentesis, but has not definitively been shown to prevent pneumothorax or reexpansion pulmonary edema. As chest discomfort correlates with negative pleural pressures, we aimed to determine whether the use of manometry could anticipate the development of chest discomfort during therapeutic thoracentesis. ⋯ In our retrospective study, the use of manometry did not appear to anticipate the development of chest discomfort during therapeutic thoracentesis. Prospective studies are needed to confirm these findings.
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J Bronchology Interv Pulmonol · Oct 2014
Enhancement of conventional TBNA outcome after EBUS Training.
Conventional transbronchial needle aspiration (C-TBNA) is a well-established technique for the diagnosis and staging of bronchogenic carcinoma. Because of the implementation of the endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA), the C-TBNA is being used less frequently. Despite its proven diagnostic utility some of the pulmonary fellowship programs have chosen to eliminate training for C-TBNA from their curriculum. The objective our study was to compare the outcomes of C-TBNA before and after the implementation of EBUS in our unit. ⋯ Diagnostic performance of C-TBNA improves after EBUS training. C-TBNA should remain in the armamentarium of every bronchoscopist and on the curriculum of all pulmonary fellowship training programs even if EBUS technology is available.
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J Bronchology Interv Pulmonol · Oct 2014
Randomized Controlled Trial Multicenter StudyThe IBV Valve trial: a multicenter, randomized, double-blind trial of endobronchial therapy for severe emphysema.
Lung volume reduction surgery improves quality of life, exercise capacity, and survival in selected patients but is accompanied by significant morbidity. Bronchoscopic approaches may provide similar benefits with less morbidity. ⋯ This trial had technical and statistical success but partial-bilateral endobronchial valve occlusion did not obtain clinically meaningful results. Safety results were acceptable and compare favorably to lung volume reduction surgery and other bronchial valve studies. Further studies need to focus on improved patient selection and a different treatment algorithm.
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J Bronchology Interv Pulmonol · Oct 2014
Case ReportsPseudo-tumor mimicking indwelling pleural catheter tract metastasis in mesothelioma.
Patients with malignant mesothelioma are known to be at risk of developing needle tract metastasis from seeding of malignant cells at the pleural intervention site. Histologic confirmation of needle tract metastases is seldom sought. The diagnosis and management (often radiotherapy) are almost always based on clinical judgment of new subcutaneous lesions at prior pleural puncture sites in mesothelioma patients. ⋯ Biopsies of both lesions revealed benign etiologies and both resolved without requiring irradiation. These cases remind clinicians that new subcutaneous lesions can be benign even when arising at pleural puncture sites of malignant pleural mesothelioma patients. Percutaneous biopsy can clarify the diagnosis in suitable cases.