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Chest：肺部结节三种引导性支气管镜检查的随机比较研究

2019-11-23 xiangting MedSci原创

周围性肺部结节支气管镜电磁导航支气管镜径向支气管内超声机器人支气管镜
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在尸体模型中与现有技术相比，使用RB明显提高了定位和成功穿刺小型PPNs的能力。这项研究证明RB可以精确到达、定位和穿刺肺周围小结节的潜力。

支气管镜诊断周围性肺部结节（PPNs）的能力仍然有限。尽管经过数十年的努力，证据表明电磁导航支气管镜（EMN）和径向支气管内超声（EBUS）的诊断准确性仅为50％。机器人支气管镜检查（RB）的新进展可能会改善PPNs的评估。

这是一项前瞻性单盲随机对照比较研究，在PPNs<2cm的人体尸体模型中使用径向EBUS（UTB-rEBUS）vs EMN vs RB超薄支气管镜评估PPNs的定位和穿刺成功率。主要终点是能够成功定位和穿刺靶结节的能力，对RB和EMN进行比较，通过锥束CT进行验证。次要终点包括穿刺针到目标位置的“未命中”距离，以及UTB-rEBUS比较。

在研究期间，对20个PPNs进行了60次手术。PPNs分布在各个肺叶上，其中80％位于肺周围。目标PPN的平均直径为16.5±1.5毫米，其中50％具有CT支气管征。与EMN相比，使用RB时PPN定位和穿刺的成功率更高（80％vs 45％；P= .02）。在未成功穿刺中，比较UTB-rEBUS、EMN和RB时，穿刺针到目标位置的“未命中”距离有明显差异（P= .0014）。

在尸体模型中与现有技术相比，使用RB明显提高了定位和成功穿刺小型PPNs的能力。这项研究证明RB可以精确到达、定位和穿刺肺周围小结节的潜力。

原始出处：

Lonny Yarmus. A Prospective Randomized Comparative Study of Three Guided Bronchoscopic Approaches for Investigating Pulmonary Nodules. Chest. 01 November 2019.

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    2020-09-07 zjubiostat

    #支气管#

    0

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    2020-07-08 zhangjiqing

    #肺部结节#

    0

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    2019-12-02 12498dd9m11暂无昵称

    #支气管镜检查#

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    2020-10-27 Smile2680

    #Chest#

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=1892211, encodeId=04531892211eb, content=<a href='/topic/show?id=1b445e1232d' target=_blank style='color:#2F92EE;'>#支气管#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=57123, encryptionId=1b445e1232d, topicName=支气管)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f503121, createdName=zjubiostat, createdTime=Mon Sep 07 03:21:00 CST 2020, time=2020-09-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1997371, encodeId=b6c5199e371b1, content=<a href='/topic/show?id=6f69823648e' target=_blank style='color:#2F92EE;'>#肺部结节#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=82364, encryptionId=6f69823648e, topicName=肺部结节)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5ee4187, createdName=zhangjiqing, createdTime=Wed Jul 08 15:21:00 CST 2020, time=2020-07-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1937061, encodeId=cc78193e06156, content=<a href='/topic/show?id=f1fd5e1751e' target=_blank style='color:#2F92EE;'>#支气管镜检查#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=57175, encryptionId=f1fd5e1751e, topicName=支气管镜检查)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b3ad2500191, createdName=12498dd9m11暂无昵称, createdTime=Mon Dec 02 10:21:00 CST 2019, time=2019-12-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1929595, encodeId=ad57192959535, content=<a href='/topic/show?id=9e604625ab' target=_blank style='color:#2F92EE;'>#Chest#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=4625, encryptionId=9e604625ab, topicName=Chest)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c48a270, createdName=Smile2680, createdTime=Tue Oct 27 10:21:00 CST 2020, time=2020-10-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2051469, encodeId=8d8820514697b, content=<a href='/topic/show?id=95f8e042dd' target=_blank style='color:#2F92EE;'>#EST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7042, encryptionId=95f8e042dd, topicName=EST)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e9a6357, createdName=xiangyuzhou971, createdTime=Sat Nov 07 06:21:00 CST 2020, time=2020-11-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1372048, encodeId=b63f13e204879, content=<a href='/topic/show?id=96965e171e8' target=_blank style='color:#2F92EE;'>#支气管镜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=57171, encryptionId=96965e171e8, topicName=支气管镜)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ff98335, createdName=liuyiping, createdTime=Mon Nov 25 08:21:00 CST 2019, time=2019-11-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1038896, encodeId=d52b103889627, content=高质量研究，读起来真爽，谢谢梅斯, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=肿瘤克星, createdTime=Sat Nov 23 20:21:00 CST 2019, time=2019-11-23, status=1, ipAttribution=)]
    2020-11-07 xiangyuzhou971

    #EST#

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=1892211, encodeId=04531892211eb, content=<a href='/topic/show?id=1b445e1232d' target=_blank style='color:#2F92EE;'>#支气管#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=57123, encryptionId=1b445e1232d, topicName=支气管)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f503121, createdName=zjubiostat, createdTime=Mon Sep 07 03:21:00 CST 2020, time=2020-09-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1997371, encodeId=b6c5199e371b1, content=<a href='/topic/show?id=6f69823648e' target=_blank style='color:#2F92EE;'>#肺部结节#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=82364, encryptionId=6f69823648e, topicName=肺部结节)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5ee4187, createdName=zhangjiqing, createdTime=Wed Jul 08 15:21:00 CST 2020, time=2020-07-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1937061, encodeId=cc78193e06156, content=<a href='/topic/show?id=f1fd5e1751e' target=_blank style='color:#2F92EE;'>#支气管镜检查#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=57175, encryptionId=f1fd5e1751e, topicName=支气管镜检查)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b3ad2500191, createdName=12498dd9m11暂无昵称, createdTime=Mon Dec 02 10:21:00 CST 2019, time=2019-12-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1929595, encodeId=ad57192959535, content=<a href='/topic/show?id=9e604625ab' target=_blank style='color:#2F92EE;'>#Chest#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=4625, encryptionId=9e604625ab, topicName=Chest)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c48a270, createdName=Smile2680, createdTime=Tue Oct 27 10:21:00 CST 2020, time=2020-10-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2051469, encodeId=8d8820514697b, content=<a href='/topic/show?id=95f8e042dd' target=_blank style='color:#2F92EE;'>#EST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7042, encryptionId=95f8e042dd, topicName=EST)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e9a6357, createdName=xiangyuzhou971, createdTime=Sat Nov 07 06:21:00 CST 2020, time=2020-11-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1372048, encodeId=b63f13e204879, content=<a href='/topic/show?id=96965e171e8' target=_blank style='color:#2F92EE;'>#支气管镜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=57171, encryptionId=96965e171e8, topicName=支气管镜)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ff98335, createdName=liuyiping, createdTime=Mon Nov 25 08:21:00 CST 2019, time=2019-11-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1038896, encodeId=d52b103889627, content=高质量研究，读起来真爽，谢谢梅斯, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=肿瘤克星, createdTime=Sat Nov 23 20:21:00 CST 2019, time=2019-11-23, status=1, ipAttribution=)]
    2019-11-25 liuyiping

    #支气管镜#

    0

  7. [GetPortalCommentsPageByObjectIdResponse(id=1892211, encodeId=04531892211eb, content=<a href='/topic/show?id=1b445e1232d' target=_blank style='color:#2F92EE;'>#支气管#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=57123, encryptionId=1b445e1232d, topicName=支气管)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f503121, createdName=zjubiostat, createdTime=Mon Sep 07 03:21:00 CST 2020, time=2020-09-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1997371, encodeId=b6c5199e371b1, content=<a href='/topic/show?id=6f69823648e' target=_blank style='color:#2F92EE;'>#肺部结节#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=82364, encryptionId=6f69823648e, topicName=肺部结节)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5ee4187, createdName=zhangjiqing, createdTime=Wed Jul 08 15:21:00 CST 2020, time=2020-07-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1937061, encodeId=cc78193e06156, content=<a href='/topic/show?id=f1fd5e1751e' target=_blank style='color:#2F92EE;'>#支气管镜检查#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=57175, encryptionId=f1fd5e1751e, topicName=支气管镜检查)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b3ad2500191, createdName=12498dd9m11暂无昵称, createdTime=Mon Dec 02 10:21:00 CST 2019, time=2019-12-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1929595, encodeId=ad57192959535, content=<a href='/topic/show?id=9e604625ab' target=_blank style='color:#2F92EE;'>#Chest#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=4625, encryptionId=9e604625ab, topicName=Chest)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c48a270, createdName=Smile2680, createdTime=Tue Oct 27 10:21:00 CST 2020, time=2020-10-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2051469, encodeId=8d8820514697b, content=<a href='/topic/show?id=95f8e042dd' target=_blank style='color:#2F92EE;'>#EST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7042, encryptionId=95f8e042dd, topicName=EST)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e9a6357, createdName=xiangyuzhou971, createdTime=Sat Nov 07 06:21:00 CST 2020, time=2020-11-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1372048, encodeId=b63f13e204879, content=<a href='/topic/show?id=96965e171e8' target=_blank style='color:#2F92EE;'>#支气管镜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=57171, encryptionId=96965e171e8, topicName=支气管镜)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ff98335, createdName=liuyiping, createdTime=Mon Nov 25 08:21:00 CST 2019, time=2019-11-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1038896, encodeId=d52b103889627, content=高质量研究，读起来真爽，谢谢梅斯, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=肿瘤克星, createdTime=Sat Nov 23 20:21:00 CST 2019, time=2019-11-23, status=1, ipAttribution=)]
    2019-11-23 肿瘤克星

    高质量研究，读起来真爽，谢谢梅斯

    0