Journal of bronchology & interventional pulmonology
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Inflammatory pseudotumors are rare solid, non-neoplastic masses that can mimic pulmonary malignancy. It occurs most commonly in children and young adults and is usually found incidentally. ⋯ The occurrence of this tumor exclusively in the pleura has not been described before. We present a case of inflammatory pseudotumor of the pleura and its successful management.
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J Bronchology Interv Pulmonol · Apr 2014
Electromagnetic navigational bronchoscopy-guided fiducial markers for lung stereotactic body radiation therapy: analysis of safety, feasibility, and interfraction stability.
Embolization coils as fiducial markers for pulmonary stereotactic body radiation therapy (SBRT) are perceived to be the optimal marker type, given their ability to conform and anchor within the small airways. The aim of our study was to assess retention, placement, migration, feasibility, and safety of electromagnetic navigational bronchoscopy (ENB)-guided embolization coil markers throughout courses of SBRT. ⋯ ENB placement of embolization coils as fiducials for lung SBRT image guidance is associated with a low rate of iatrogenic pneumothoraces, and resulted in reliable placement of the fiducials in close proximity to the lung nodule. Embolization coils retained their relative position to the nodule throughout the course of SBRT, and provide an excellent alternative to linear gold seeds.
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J Bronchology Interv Pulmonol · Apr 2014
Bronchoscopic training and practice in australia and New Zealand is inconsistent with published society guidelines.
The Australasian practice and training in bronchoscopy has not previously been reported and procedure volumes among Australasian respiratory consultants and trainees are unknown. We surveyed the current practice of flexible bronchoscopy in Australasia and determined adherence to published recommendations. ⋯ A large proportion of Australasian bronchoscopists do not meet "numbers-based" recommendations. This empirical data support the 2012 TSANZ interventional guidelines' call to move beyond procedural volume as the sole determinant of technical competence. There is an urgent need to explore alternative means of developing and defining bronchoscopic proficiency.
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J Bronchology Interv Pulmonol · Jan 2014
Endobronchial ultrasound-guided biopsy performed under optimal conditions in patients with known or suspected lung cancer may render mediastinoscopy unnecessary.
Mediastinoscopy is the gold standard for preoperative mediastinal staging of patients with suspected or proven lung cancer. Since the development of endoscopic ultrasound-guided biopsy via the trachea (EBUS-TBNA), this status has been challenged. The purpose of the study was to examine whether mediastinoscopy is necessary, when EBUS-TBNA is performed in a center with (1) a high level of expertise, (2) "bed side" microscopy by a pathologist, (3) general anesthesia, and (4) achievement of representative tissue from station 4R, 7 and 4L, that is, the same mediastinal stations that mediastinoscopy gives access to. ⋯ When EBUS-TBNA is performed under optimal conditions including general anesthesia and "bed side" microscopy performed by a pathologist resulting in representative biopsies from station 4R, 7, and 4L, the NPV is so high that mediastinoscopy seems unnecessary.
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J Bronchology Interv Pulmonol · Jan 2014
The usefulness of endobronchial ultrasonography-guided transbronchial needle aspiration at the lobar, segmental, or subsegmental bronchus smaller than a convex-type bronchoscope.
Endobronchial ultrasonography-guided transbronchial needle aspiration (EBUS-TBNA) is a standard procedure for approaching the lesion adjacent to extrapulmonary bronchus. We started to use wedge insertion of a convex endobronchial ultrasound bronchoscope into bronchi narrower than the diameter of the bronchoscope itself to perform EBUS-TBNA. Our objective was to investigate the bronchus in which EBUS-TBNA was possible and safe. ⋯ EBUS-TBNA can be performed by inserting a 6.9 mm EBUS bronchoscope into airways with a mean diameter ≥ 4.5 mm as measured on computed tomography before bronchoscopy.