Brazilian Journal of Pulmonology

ISSN (on-line): 1806-3756 | ISSN (printed): 1806-3713

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Radial-probe EBUS for the diagnosis of peripheral pulmonary lesions

Ecobroncoscopia radial para o diagnóstico de lesões pulmonares periféricas

Marcia Jacomelli, Sergio Eduardo Demarzo, Paulo Francisco Guerreiro Cardoso, Addy Lidvina Mejia Palomino, Viviane Rossi Figueiredo

J Bras Pneumol.2016;42(4):248-253

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Objective: Conventional bronchoscopy has a low diagnostic yield for peripheral pulmonary lesions. Radial-probe EBUS employs a rotating ultrasound transducer at the end of a probe that is passed through the working channel of the bronchoscope. Radial-probe EBUS facilitates the localization of peripheral pulmonary nodules, thus increasing the diagnostic yield. The objective of this study was to present our initial experience using radial-probe EBUS in the diagnosis of peripheral pulmonary lesions at a tertiary hospital. Methods: We conducted a retrospective analysis of 54 patients who underwent radial-probe EBUS-guided bronchoscopy for the investigation of pulmonary nodules or masses between February of 2012 and September of 2013. Radial-probe EBUS was performed with a flexible 20-MHz probe, which was passed through the working channel of the bronchoscope and advanced through the bronchus to the target lesion. For localization of the lesion and for collection procedures (bronchial brushing, transbronchial needle aspiration, and transbronchial biopsy), we used fluoroscopy. Results: Radial-probe EBUS identified 39 nodules (mean diameter, 1.9 ± 0.7 cm) and 19 masses (mean diameter, 4.1 ± 0.9 cm). The overall sensitivity of the method was 66.7% (79.5% and 25.0%, respectively, for lesions that were visible and not visible by radial-probe EBUS). Among the lesions that were visible by radial-probe EBUS, the sensitivity was 91.7% for masses and 74.1% for nodules. The complications were pneumothorax (in 3.7%) and bronchial bleeding, which was controlled bronchoscopically (in 9.3%). Conclusions: Radial-probe EBUS shows a good safety profile, a low complication rate, and high sensitivity for the diagnosis of peripheral pulmonary lesions.

 


Keywords: Diagnostic techniques, respiratory system; Lung/ultrasonography; Bronchoscopy/methods; Bronchoscopy/instrumentation.

 


Erratum: Radial-probe EBUS for the diagnosis of peripheral pulmonary lesions.

Errata: Ecobroncoscopia radial para o diagnóstico de lesões pulmonares periféricas.

Marcia Jacomelli1, Sergio Eduardo Demarzo1, Paulo Francisco Guerreiro Cardoso2, Addy Lidvina Mejia Palomino1, Viviane Rossi Figueiredo1

J Bras Pneumol.2017;43(1):78-79

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Endobronchial ultrasound-guided transbronchial needle aspiration for lung cancer staging: early experience in Brazil

Punção aspirativa por agulha guiada por ultrassom endobrônquico no estadiamento do câncer de pulmão: experiência inicial no Brasil

Viviane Rossi Figueiredo, Paulo Francisco Guerreiro Cardoso, Márcia Jacomelli, Sérgio Eduardo Demarzo, Addy Lidvina Mejia Palomino, Ascédio José Rodrigues, Ricardo Mingarini Terra, Paulo Manoel Pego-Fernandes, Carlos Roberto Ribeiro Carvalho

J Bras Pneumol.2015;41(1):23-30

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Objective: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a minimally invasive, safe and accurate method for collecting samples from mediastinal and hilar lymph nodes. This study focused on the initial results obtained with EBUS-TBNA for lung cancer and lymph node staging at three teaching hospitals in Brazil. Methods: This was a retrospective analysis of patients diagnosed with lung cancer and submitted to EBUS-TBNA for mediastinal lymph node staging. The EBUS-TBNA procedures, which involved the use of an EBUS scope, an ultrasound processor, and a compatible, disposable 22 G needle, were performed while the patients were under general anesthesia. Results: Between January of 2011 and January of 2014, 149 patients underwent EBUS-TBNA for lymph node staging. The mean age was 66 ± 12 years, and 58% were male. A total of 407 lymph nodes were sampled by EBUS-TBNA. The most common types of lung neoplasm were adenocarcinoma (in 67%) and squamous cell carcinoma (in 24%). For lung cancer staging, EBUS-TBNA was found to have a sensitivity of 96%, a specificity of 100%, and a negative predictive value of 85%. Conclusions: We found EBUS-TBNA to be a safe and accurate method for lymph node staging in lung cancer patients.

 


Keywords: Lung neoplasms; Neoplasm staging; Bronchoscopy; Endoscopic ultrasound-guided fine needle aspiration; Lymph nodes.

 


Authors' reply

Resposta dos autores

Marcia Jacomelli1, Sergio Eduardo Demarzo1, Paulo Francisco Guerreiro Cardoso2, Addy Lidvina Mejia Palomino1, Viviane Rossi Figueiredo1

J Bras Pneumol.2017;43(1):77-77

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