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Chaddha U , Kovacs SP , Manley C , Hogarth DK , Cumbo-Nacheli G , Bhavani SV , Kumar R , Shende M , Egan JP 3rd , Murgu S
Robot-assisted bronchoscopy for pulmonary lesion diagnosis: results from the initial multicenter experience
BMC Pulm Med. 2019 Dec 11;19(1) :243
PMID: 31829148    PMCID: PMC6907137   
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BACKGROUND: The Robotic Endoscopic System (Auris Health, Inc., Redwood City, CA) has the potential to overcome several limitations of contemporary guided-bronchoscopic technologies for the diagnosis of lung lesions. Our objective is to report on the initial post-marketing feasibility, safety and diagnostic yield of this technology. METHODS: We retrospectively reviewed data on consecutive cases in which robot-assisted bronchoscopy was used to sample lung lesions at four centers in the US (academic and community) from June 15th, 2018 to December 15th, 2018. RESULTS: One hundred and sixty-seven lesions in 165 patients were included in the analysis, with an average follow-up of 185 +/- 55 days. The average size of target lesions was 25.0 +/- 15.0 mm. Seventy-one percent were located in the peripheral third of the lung. Pneumothorax and airway bleeding occurred in 3.6 and 2.4% cases, respectively. Navigation was successful in 88.6% of cases. Tissue samples were successfully obtained in 98.8%. The diagnostic yield estimates ranged from 69.1 to 77% assuming the cases of biopsy-proven inflammation without any follow-up information (N = 13) were non-diagnostic and diagnostic, respectively. The yield was 81.5, 71.7 and 26.9% for concentric, eccentric and absent r-EBUS views, respectively. Diagnostic yield was not affected by lesion size, density, lobar location or centrality. CONCLUSIONS: RAB implementation in community and academic centers is safe and feasible, with an initial diagnostic yield of 69.1-77% in patients with lung lesions that require diagnostic bronchoscopy. Comparative trials with the existing bronchoscopic technologies are needed to determine cost-effectiveness of this technology.
1471-2466 Chaddha, Udit ORCID: http://orcid.org/0000-0003-0067-1616 Kovacs, Stephen P Manley, Christopher Hogarth, D Kyle Cumbo-Nacheli, Gustavo Bhavani, Sivasubramanium V Kumar, Rohit Shende, Manisha Egan, John P 3rd Murgu, Septimiu Journal Article England BMC Pulm Med. 2019 Dec 11;19(1):243. doi: 10.1186/s12890-019-1010-8.