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Factors Associated With Diagnostic Accuracy of Robotic Bronchoscopy With 12-Month Follow-up.

Authors:
Abhinav Agrawal Elliot Ho Udit Chaddha Baris Demirkol Sivasubramanium V Bhavani D Kyle Hogarth Septimiu Murgu

Ann Thorac Surg 2022 Jan 17. Epub 2022 Jan 17.

Section of Pulmonary and Critical Care, The University of Chicago, Chicago, Illinois.

Background: Robotic bronchoscopy (RB) aims to increase the diagnostic yield of guided bronchoscopy by providing improved navigation, farther reach, and stability during lesion sampling.

Methods: We reviewed data on consecutive cases in which RB was used to diagnose lung lesions from June 15, 2018, to December 15, 2019, at the University of Chicago Medical Center.

Results: The median lesion size was 20.5 mm. All patients had at least 12 months of follow-up. The overall diagnostic accuracy was 77% (95 of 124). The diagnostic accuracy was 85%, 84%, and 38% for concentric, eccentric, and absent radial endobronchial ultrasound (r-EBUS) views, respectively (P < .001). A positive r-EBUS view and lesions size of 20 to 30 mm had higher odds of achieving a diagnosis on multivariate analysis. The 12-month diagnostic accuracy, sensitivity, specificity, and positive and negative predictive value for malignancy were 77%, 69%, 100%, 100%, and 58%, respectively. Pneumothorax was noted in 1.6% (n = 2) patients with bleeding reported in 3.2% (n = 4). No postprocedure respiratory failure was noted.

Conclusions: The overall diagnostic accuracy using RB for pulmonary lesion sampling in our cohort with 12-month follow-up compared favorably with established guided bronchoscopy technologies. Lesion size ≥20 mm and confirmation by r-EBUS predicted higher accuracy independent of concentric or eccentric r-EBUS patterns.

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http://dx.doi.org/10.1016/j.athoracsur.2021.12.041DOI Listing
January 2022

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