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Corcoran A, Shore D, Boesch RP, Chopra M, Das S, DiBardino D, Goldfarb S, Haas A, Hysinger E, Phinizy P, Vicencio A, Toth J, Piccione J. Practices and perspectives on advanced diagnostic and interventional bronchoscopy among pediatric pulmonologists in the United States. Pediatr Pulmonol 2024; 59:1708-1715. [PMID: 38558404 DOI: 10.1002/ppul.26977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 02/18/2024] [Accepted: 03/10/2024] [Indexed: 04/04/2024]
Abstract
INTRODUCTION Advanced diagnostic bronchoscopy includes endobronchial ultrasound (EBUS) guided transbronchial lung and lymph node biopsies, CT navigation and robotic bronchoscopy. Interventional bronchoscopy refers to procedures performed for therapeutic purposes such as balloon dilation of the airway, tissue debulking, cryotherapy, removal of foreign bodies and insertion of endobronchial valves [1]. For adult patients, these procedures are standard of care [2, 3]. Despite a lack of formalized training, there are numerous case reports and case series describing the use of advanced diagnostic and interventional bronchoscopy techniques in children. The safety and feasibility of EBUS-TBNA, cryotherapy techniques, endobronchial valves among other techniques have been demonstrated in these publications [1, 4-9]. METHODS We sought to better understand the current practices and perspectives on interventional and advanced bronchoscopy among pediatric pulmonologists through surveys sent to pediatric teaching hospitals across the United States. RESULTS We received 43 responses representing 28 programs from 25 states. The highest bronchoscopy procedure volume occurred in the 0-5 years age group. Among our respondents, 31% self-identified as a pediatric interventional/advanced bronchoscopist. 79% believe that advanced and interventional training is feasible in pediatric pulmonology and 77% believe it should be offered to pediatric pulmonary fellows. DISCUSSION This is the first study to characterize current practices and perspectives regarding advanced diagnostic and interventional bronchoscopy procedures among pediatric pulmonologists in the United States. Pediatric interventional pulmonology (IP) is in its infancy and its beginnings echo those of the adult IP where only certain centers were performing these procedures.
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Affiliation(s)
- A Corcoran
- Division of Pulmonary and sleep medicine, Children's Hospital Of Philadelphia, Philadelphia, PA
| | - D Shore
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, Penn State Health Milton S. Hershey Medical Center, Hershey, PA
| | - R P Boesch
- Mayo Clinic, Children's Center, Pediatric and Adolescent Medicine, Rochester, Minnesota
| | - M Chopra
- Division of Pulmonary, The University of Arizona, Tucson, Arizona
| | - S Das
- Section of Pediatric Pulmonary Medicine, Department of Pediatrics, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas
| | - D DiBardino
- Division of Pulmonary, Allergy, and Critical Care Medicine Perelman School of Medicine, University of Pennsylvania Philadelphia, PA
| | - S Goldfarb
- Division of Pulmonary and Sleep Medicine, University of Minnesota, Masonic Children's Hospital, Minneapolis, Minnesota
| | - A Haas
- Division of Pulmonary, Allergy, and Critical Care Medicine Perelman School of Medicine, University of Pennsylvania Philadelphia, PA
| | - E Hysinger
- Division of Pulmonary Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - P Phinizy
- Division of Pulmonary and sleep medicine, Children's Hospital Of Philadelphia, Philadelphia, PA
| | - A Vicencio
- Division of Pulmonary Medicine, Icahn School of Medicine at Mount Sinai, New York, New York
| | - J Toth
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, Penn State Health Milton S. Hershey Medical Center, Hershey, PA
| | - J Piccione
- Division of Pulmonary and sleep medicine, Children's Hospital Of Philadelphia, Philadelphia, PA
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Briski K, Labib B, Hussain S, Ramagopal M, Uppaluri L. Novel therapies for eosinophilic pediatric plastic bronchitis. Pediatr Pulmonol 2024; 59:1792-1794. [PMID: 38488768 DOI: 10.1002/ppul.26974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Revised: 02/12/2024] [Accepted: 03/08/2024] [Indexed: 05/28/2024]
Affiliation(s)
| | | | - Sabiha Hussain
- Rutgers Robert Wood Johnson Medical School, New Brunswick, USA
| | - Maya Ramagopal
- Rutgers Robert Wood Johnson Medical School, New Brunswick, USA
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Januska MN, Kaspy K, Bozkanat KM, Vicencio AG. Pediatric interventional bronchoscopy: from early limitations to achievable opportunities. Curr Opin Pulm Med 2024; 30:107-117. [PMID: 37933635 PMCID: PMC10842060 DOI: 10.1097/mcp.0000000000001029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2023]
Abstract
PURPOSE OF REVIEW The rapid evolution of bronchoscopy equipment and technologies, from the introduction of the 1.1 mm flexible cryoprobe to the use of navigational and robotic bronchoscopy, has afforded unprecedented opportunities for pediatric advanced diagnostic and interventional bronchoscopy. While there is growing interest among pediatric pulmonologists to incorporate these new techniques into their practice, the current pediatric landscape is characterized by few practicing interventional bronchoscopists, scant published literature, and no formal training programs. RECENT FINDINGS While the majority of the published literature consists of case reports and small case series, the increased application of new techniques is starting to yield larger and more structured studies that will be able to provide more objective commentary on the proposed indications, safety, and efficacy of such techniques in the pediatric population. SUMMARY For many decades, progress in pediatric advanced diagnostic and interventional bronchoscopy was slow and deliberate, limited by the lack of appropriately sized equipment and experienced interventional bronchoscopists. The current opportunities afforded require equal, or perhaps even more, vigilance as pediatric pulmonologists employ new equipment and technologies and define new practices and standards of care. Importantly, this review is meant to serve as a general conspectus of pediatric advanced diagnostic and interventional bronchoscopy and not a consensus guideline for the performance of advanced or even routine bronchoscopy in the pediatric population. For technical standards of pediatric bronchoscopy, refer to existing guidelines [1,2] .
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Affiliation(s)
- Megan N Januska
- Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Kimberley Kaspy
- Division of Pediatric Respiratory Medicine, Montreal Children’s Hospital, Montreal, QC, CA
| | - Kubra M Bozkanat
- Division of Pulmonary Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
| | - Alfin G Vicencio
- Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Goussard P, Eber E, Venkatakrishna S, Frigati L, Greybe L, Janson J, Schubert P, Andronikou S. Interventional bronchoscopy in pediatric pulmonary tuberculosis. Expert Rev Respir Med 2023; 17:1159-1175. [PMID: 38140708 DOI: 10.1080/17476348.2023.2299336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 12/21/2023] [Indexed: 12/24/2023]
Abstract
INTRODUCTION Lymphobronchial tuberculosis (TB) is common in children with primary TB and enlarged lymph nodes can cause airway compression of the large airways. If not treated correctly, airway compression can result in persistent and permanent parenchymal pathology, as well as irreversible lung destruction. Bronchoscopy was originally used to collect diagnostic samples; however, its role has evolved, and it is now used as an interventional tool in the diagnosis and management of complicated airway disease. Endoscopic treatment guidelines for children with TB are scarce. AREAS COVERED The role of interventional bronchoscopy in the diagnosis and management of complicated pulmonary TB will be discussed. This review will provide practical insights into how and when to perform interventional procedures in children with complicated TB for both diagnostic and therapeutic purposes. This discussion incorporates current scientific evidence and refers to adult literature, as some of the interventions have only been done in adults but may have a role in children. Limitations and future perspectives will be examined. EXPERT OPINION Pediatric pulmonary TB lends itself to endoscopic interventions as it is a disease with a good outcome if treated correctly. However, interventions must be limited to safeguard the parenchyma and prevent permanent damage.
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Affiliation(s)
- Pierre Goussard
- Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University and Tygerberg Hospital, Cape Town, South Africa
| | - Ernst Eber
- Division of Paediatric Pulmonology and Allergology, Department of Paediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria
| | - Shyam Venkatakrishna
- Department of Pediatric Radiology, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Lisa Frigati
- Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University and Tygerberg Hospital, Cape Town, South Africa
| | - Leonore Greybe
- Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University and Tygerberg Hospital, Cape Town, South Africa
| | - Jacques Janson
- Department of Surgical Sciences, Division of Cardiothoracic Surgery, Stellenbosch University and Tygerberg Hospital, Cape Town, South Africa
| | - Pawel Schubert
- Division of Anatomical Pathology, Tygerberg Hospital, National Health Laboratory Service, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Savvas Andronikou
- Department of Pediatric Radiology, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
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Tayal A, Shekh I, Karthik AR, Jat KR, Dhochak N, Mittal S, Gupta N, Kabra SK, Madan K. A "Cool" extraction technique for difficult pediatric airway foreign bodies: Report of two cases. Pediatr Pulmonol 2023; 58:2670-2674. [PMID: 37265423 DOI: 10.1002/ppul.26530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 04/19/2023] [Accepted: 05/24/2023] [Indexed: 06/03/2023]
Abstract
Foreign body (FB) aspiration is a potentially life-threatening accident in children. Traditionally, rigid bronchoscopy has been the procedure of choice for FB removal, however it may miss distally lodged FBs. We report two pediatric cases with distal impacted FBs that could not be retrieved by rigid bronchoscopy (RB) and were mobilised using Fogarty balloon followed by flexible bronchoscopic cryoextraction. The advantage of a cryoprobe is lower risk of fragmentation of FB that may occur with forceps. Cryoextraction is particularly advantageous for removing water-containing FBs. In both patients, FB was removed more than 2 weeks following aspiration, leading to the formation of granulation tissue around the FB, which considerably hampered the process. Using a laryngeal mask airway to secure the airway, FB removal by flexible bronchoscopy may be a safe and effective technique in skilled hands, especially for FBs impacted in distal airways with granulation tissue where RB fails.
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Affiliation(s)
- Anshula Tayal
- Department of Pediatrics, Division of Pediatric Pulmonology and Intensive Care, All India Institute of Medical Sciences, New Delhi, India
| | - Irfan Shekh
- Department of Pulmonary, Critical Care and Sleep Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - A R Karthik
- Department of Anaesthesia, Pain and Palliative Care, Cancer Institute (WIA), Adyar, Chennai, Tamil Nadu, India
| | - Kana Ram Jat
- Department of Pediatrics, Division of Pediatric Pulmonology and Intensive Care, All India Institute of Medical Sciences, New Delhi, India
| | - Nitin Dhochak
- Department of Pediatrics, Division of Pediatric Pulmonology and Intensive Care, All India Institute of Medical Sciences, New Delhi, India
| | - Saurabh Mittal
- Department of Pulmonary, Critical Care and Sleep Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Nishkarsh Gupta
- Department of Onco-Anaesthesia and Palliative Medicine, Dr. BRAIRCH, All India Institute of Medical Sciences, New Delhi, India
| | - Sushil K Kabra
- Department of Pediatrics, Division of Pediatric Pulmonology and Intensive Care, All India Institute of Medical Sciences, New Delhi, India
| | - Karan Madan
- Department of Pulmonary, Critical Care and Sleep Medicine, All India Institute of Medical Sciences, New Delhi, India
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Truitt BA, Kasi AS, Kamat PP, Fundora MP, Simon DM, Guglani L. Cryoextraction via flexible bronchoscopy in children with tracheobronchial obstruction. Pediatr Pulmonol 2023; 58:2527-2534. [PMID: 37350368 DOI: 10.1002/ppul.26540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Revised: 05/19/2023] [Accepted: 05/26/2023] [Indexed: 06/24/2023]
Abstract
BACKGROUND Cryoextraction via flexible bronchoscopy (FB) can be used to alleviate airway obstruction due to blood clots, casts, mucus, and foreign bodies. There is limited literature regarding the utility of cryoextraction to restore airway patency in critically ill children, especially on extracorporeal membrane oxygenation (ECMO). The aims of this study were to describe the clinical course and outcomes of children who underwent cryoextraction via FB. METHODS A singlecenter retrospective review of children who underwent cryoextraction via FB between 2017 and 2021 was conducted. The analyzed data included diagnoses, indications for cryoextraction, respiratory support modalities, FB and chest imaging results, and outcomes. RESULTS Eleven patients aged 3-17 years underwent a total of 33 cryoextraction sessions via FB. Patients required ECMO (n = 9) or conventional mechanical ventilation (CMV) for pneumonia, pulmonary hemorrhage, pulmonary embolism, asthma exacerbation, and cardiorespiratory failure following cardiac surgery. One patient underwent elective FB and cryoextraction for plastic bronchitis. Indications for cryoextraction included airway obstruction due to tracheobronchial thrombi (n = 8), mucus plugs (n = 1), or plastic bronchitis (n = 2). Cryoextraction via FB was performed on patients on ECMO (n = 9) and CMV (n = 2) with 6 patients requiring ≥3 cryoextraction sessions for airway obstruction. There were no complications related to cryoextraction. Patient outcomes included partial (n = 5) or complete (n = 6) restoration of airway patency with ECMO decannulation (n = 5) and death (n = 4) due to critical illness. CONCLUSIONS Cryoextraction via FB is an effective intervention that can be utilized in critically ill children with refractory tracheobronchial obstruction to restore airway patency and to facilitate liberation from ECMO.
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Affiliation(s)
- Brittany A Truitt
- Division of Pediatric Pulmonology, Department of Pediatrics, Emory University and Children's Healthcare of Atlanta, Atlanta, Georgia, USA
| | - Ajay S Kasi
- Division of Pediatric Pulmonology, Department of Pediatrics, Emory University and Children's Healthcare of Atlanta, Atlanta, Georgia, USA
| | - Pradip P Kamat
- Division of Pediatric Critical Care Medicine, Department of Pediatrics, Emory University and Children's Healthcare of Atlanta, Atlanta, Georgia, USA
| | - Michael P Fundora
- Division of Pediatric Cardiology, Department of Pediatrics, Emory University and Children's Healthcare of Atlanta, Atlanta, Georgia, USA
| | - Dawn M Simon
- Division of Pediatric Pulmonology, Department of Pediatrics, Emory University and Children's Healthcare of Atlanta, Atlanta, Georgia, USA
| | - Lokesh Guglani
- Division of Pediatric Pulmonology, Department of Pediatrics, Emory University and Children's Healthcare of Atlanta, Atlanta, Georgia, USA
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Keil O, Schwerk N. Foreign body aspiration in children - being safe and flexible. Curr Opin Anaesthesiol 2023; 36:334-339. [PMID: 36745076 DOI: 10.1097/aco.0000000000001251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
PURPOSE OF REVIEW Anesthesia for foreign body removal in children can be quite challenging. Even though rigid bronchoscopy is considered the gold standard for foreign body removal, there is increasing evidence for successful foreign body removal using flexible bronchoscopy. This review discusses the recent implications for flexible bronchoscopy for the purpose of foreign body removal and will compare these findings to rigid bronchoscopy. RECENT FINDINGS During the last few years, several observational studies on foreign body removal by flexible bronchoscopy have been published, with promising results. SUMMARY Flexible bronchoscopy is a feasible and safe method for removing aspirated foreign bodies in children. In order to improve patient safety during the procedure, it is necessary for a pediatric anesthetist and a pediatric pulmonologist to work closely together. The anesthetist can take care of the administration of the anesthetic and maintenance of the vital functions, and the pulmonologist can carry out a safe and fast bronchoscopy. In the case of foreign body removal by flexible bronchoscopy, the anesthesiological procedure of choice should be general anesthesia with controlled ventilation via a laryngeal mask.
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Affiliation(s)
- Oliver Keil
- Clinic of Anesthesiology and Intensive Care Medicine
| | - Nicolaus Schwerk
- Clinic of Pediatric Pulmonology, Allergology and Neonatology, Hannover Medical School
- BREATH (Biomedical Research in End-stage and obstructive Lung Disease Hannover), German Center for Lung Research (DZL), Hannover, Germany
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Schramm D, Vicencio A. Pediatric cryobiopsy. Pediatr Pulmonol 2023; 58:16-17. [PMID: 36199202 DOI: 10.1002/ppul.26186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 10/04/2022] [Indexed: 01/11/2023]
Affiliation(s)
- Dirk Schramm
- Department of General Pediatrics, Neonatology and Pediatric Cardiology, Medical Faculty, University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Alfin Vicencio
- Department of Paediatrics, Division of Paediatric Pulmonology, Mount Sinai Kravis Children's Hospital, Icahn School of Medicine at Mount Sinai, New York, New York, USA
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Gatt D, Golan Tripto I, Tsaregorodtsev S, Aviram M, Goldbart A. Blood clot removal by flexible bronchoscopic cryotherapy in a young child. Pediatr Int 2023; 65:e15420. [PMID: 36394378 DOI: 10.1111/ped.15420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 10/21/2022] [Accepted: 11/16/2022] [Indexed: 11/19/2022]
Affiliation(s)
- Dvir Gatt
- Department of Pediatrics, Soroka University Medical Center, Beer Sheva, Israel
- Pediatric Pulmonary Unit, Soroka University Medical Center, Beer Sheva, Israel
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Inbal Golan Tripto
- Department of Pediatrics, Soroka University Medical Center, Beer Sheva, Israel
- Pediatric Pulmonary Unit, Soroka University Medical Center, Beer Sheva, Israel
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Sergey Tsaregorodtsev
- Department of Anesthesia and Critical Care, Soroka University Medical Center, Beer Sheva, Israel
| | - Micha Aviram
- Department of Pediatrics, Soroka University Medical Center, Beer Sheva, Israel
- Pediatric Pulmonary Unit, Soroka University Medical Center, Beer Sheva, Israel
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Aviv Goldbart
- Department of Pediatrics, Soroka University Medical Center, Beer Sheva, Israel
- Pediatric Pulmonary Unit, Soroka University Medical Center, Beer Sheva, Israel
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
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Vicencio A. A paediatric bronchoscopist's 'Field of Dreams': Will the flexible cryoprobe hit a home run? Respirology 2022; 27:918-919. [PMID: 36071596 DOI: 10.1111/resp.14366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 08/29/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Alfin Vicencio
- Department of Paediatrics, Division of Paediatric Pulmonology, Mount Sinai Kravis Children's Hospital, Icahn School of Medicine at Mount Sinai, New York, New York, USA
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Yang H, Turgon E, Pan Y, Wen X, Zhang X, Shen Y, Wang F. Pilot study of archimedes virtual bronchoscopic navigation system-guided biopsy to diagnose lung nodules in children. Front Pediatr 2022; 10:1053289. [PMID: 36819191 PMCID: PMC9932915 DOI: 10.3389/fped.2022.1053289] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Accepted: 11/23/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Peripheral pulmonary lesions are uncommon in children. Bronchoscopy is a minimal invasive method to obtain a diagnostic lung biopsy. However, due to the lack of effective guidance methods, the diagnostic efficacy of transbronchial lung biopsy for peripheral solitary pulmonary diseases is still limited. RESEARCH QUESTION Is the Archimedes virtual bronchoscopic navigation system safe and effective for the diagnosis of peripheral pulmonary lesions in children? STUDY DESIGN AND METHODS This pilot study retrospectively analyzed the clinical features, radiological characteristics, operation processes, intra-and postoperative complications, and pathological results of five children who underwent Archimedes-guided biopsy of peripheral pulmonary lesions in Beijing Children's Hospital from May 2021 to May 2022. RESULTS The cohort comprised five children (all males) with age of 7.1-15.8 years. A guide sheath was inserted through the bronchoscope under the guidance of Archimedes combined with radial endobronchial ultrasound to complete the biopsy under general anesthesia. The fused fluoroscopy technique was used to reconfirm the location of the forceps prior to biopsy in all children. The forceps reached the lesion under the guidance of the navigation and the samples were collected successfully in all children. Pathological examination of the biopsy specimens showed Epstein-Barr virus infection-related lymphoproliferative disease in one child, pulmonary metastasis of rhabdomyosarcoma in one child, and pulmonary vasculitis in one child; high-throughput sequencing of the biopsy tissue sample identified Mycobacterium tuberculosis (sequence no. 80) in one child and Aspergillus (sequence no. 40) in another child. All five children tolerated the biopsy procedure without developing postoperative complications, such as pneumothorax and hemoptysis. INTERPRETATION Archimedes-guided bronchoscopic lung biopsy is a feasible and efficient way to diagnose peripheral pulmonary lesions in children with manageable complications.
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Affiliation(s)
- Haiming Yang
- Department No. 2 of Respiratory Diseases, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Elijan Turgon
- Department of Respiratory Diseases, Children's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hospital of Beijing Children's Hospita, Urumqi, China
| | - Yuena Pan
- Department of Interventional Pulmonology, Beijing Children's Hospital, Capital Medical University, National Center for Children' Health, Beijing, China
| | - Xiaohui Wen
- Department No. 2 of Respiratory Diseases, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Xiaoyan Zhang
- Department No. 2 of Respiratory Diseases, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Yuelin Shen
- Department No. 2 of Respiratory Diseases, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Feng Wang
- Department of Respiratory and Critical Care Medicine, Beijing Chaoyang Hospital, Capital Medical University, Beijing Institute of Respiratory Disease, Beijing, China
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