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%ifinthe
outer
portionoflungparenchyma) Chest 2003;123:115S128S.
CONVENTIONAL APPROACH
Ultrathinbronchoscope(2mm)andfluoroscopicguidance;64.7%
ofsensitivity(Rooney CP,Respiration2002;69:6368)
BIOPSY & RADIOLOGICAL GUIDANCE
Guidance&fluoroscopy (Chest2006;129:147150)
Irradiation
Visibility?40%(54/138)of<2.2cmlesionsarenot visible
CTscantransthoracic bx
From65to90%of
sensitivity
dependingonthe
typeoflesion
Requiresimmobility
ofthepatientduring
procedure
Riskofhemorrhage
(1020%)
Riskof
pneumothorax
(>30%)
1 / 41 100%