NAVIGATION ÉLECTROMAGNÉTIQUE: POSSIBILITÉS ET LIMITES »

NAVIGATION
ÉLECTROMAGNÉTIQUE:
POSSIBILITÉS ET LIMITES
CC, DR. PAOLA GASCHE»

LUNG TERRITORY REACHABLE BY
CONVENTIONAL BRONCHOSCOPY

THE PROBLEM OF THE
PERIPHERAL NODULE
Peripheralnodulelessthan2cmofdiametercanbereachedby
conventionalbronchoscopyonlyin30%ofcases(14%ifinthe
outer
⅓ portionoflungparenchyma) Chest 2003;123:115S128S.

CONVENTIONAL APPROACH
Ultrathinbronchoscope(2mm)andfluoroscopicguidance;64.7%
ofsensitivity(Rooney CP,Respiration2002;69:6368)

BIOPSY & RADIOLOGICAL GUIDANCE
Guidance&fluoroscopy (Chest2006;129:147150)
•Irradiation
•Visibility?40%(54/138)of<2.2cmlesionsarenot visible
CTscantransthoracic bx
•From65to90%of
sensitivity
dependingonthe
typeoflesion
•Requiresimmobility
ofthepatientduring
procedure
•Riskofhemorrhage
(1020%)
•Riskof
pneumothorax
(>30%)