Abstract 134P
Background
We evaluated diagnostic performance and complication rate of electromagnetic navigation bronchoscopy (ENB) as well as predictors of outcomes in a single-center cohort.
Methods
All patients having undergone ENB using a superDimension system (Medtronic, Minneapolis, Minnesota) at Kepler University Hospital Linz, Austria, between 2014 and 2022 were retrospectively enregistered. ENB was performed under general anaesthesia, standardized post-interventional follow-up included a chest X-ray after three hours. Severe complications were defined as pneumothorax or bronchial bleeding with need for intervention, procedure-related death, or ICU admission. Success was defined as reaching the lesion to <1cm of the predefined target and no need for further diagnostic intervention.
Results
A total of 238 separate ENB procedures in 231 patients (mean age 66 years, 58% male) were evaluated. The procedure was successful in 124 (52%), the target lesion was reached but information obtained was insufficient in 98 (41%), and the target lesion could not be reached in 16 (7%) patients. Success was significantly associated with smoking history <30 pack-years (OR 2.75, p=0.0013), lesion location in the middle (OR 3.68, p=0.002) or upper (OR 2.79, p=0.01) versus the lower lung third in the frontal plane, and with a positive bronchus sign (OR 2.95, p<0.001). Pneumothorax occurred in 32 (13.5%) patients, bronchial bleeding in 5 (2.1%), overall complication rate was 14.7%. All 11 (4.6%) severe complications were pneumothoraces requiring intervention. Predictors of overall complication rate were a location in the anterior (OR 4.32, p=0.014) or medial (OR 6.99, p<0.001) versus the posterior lung third in the horizontal plane, distance lesion to pleura <9mm (OR 6.64, p<0.001), and low PET activity (OR 2.9, p=0.045).
Conclusions
Diagnostic performance of ENB was higher in patients with less smoking history, upper- or middle frontal lung field localization and a positive bronchus sign. Complications – mainly pneumothoraces – rather occurred in lesions with low PET activity, vicinity to the pleura, and in the anterior or medial horizontal lung thirds.
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.