systematic-bronchoscopy-the-four-landmarks-approach

Systematic Bronchoscopy: the Four Landmarks Approach

Flexible bronchoscopy is a technically difficult procedure and has been identified as the most important procedure that should be integrated into a ...

systematic-endobronchial-ultrasound-the-six-landmarks-approach

Systematic Endobronchial Ultrasound - The Six Landmarks Approach

Lung cancer is the leading cause of cancer mortality globally. To ensure the correct diagnosis and staging in relation to treatment options, it is crucial ...

University of Copenhagen and the Capital Region of Denmark

Rigshospitalet, University of Copenhagen

Flexible bronchoscopy is a core invasive procedure in pulmonary medicine and training in the procedure is mandatory. Diagnostic completeness and procedure time have been identified as useful measures of competence. No outcome measures have been developed regarding navigational path in bronchoscopy to assess whether the bronchial segments have been identified in an arbitrary or structured order. We investigated whether a new outcome measure for structured progression could be used to assess competency in flexible bronchoscopy.

Using structured progress to measure competence in flexible bronchoscopy.

Motor skills have been identified as a useful measure to evaluate competency in bronchoscopy. However, no automatic assessment system of motor skills with a clear pass/fail criterion in flexible bronchoscopy exists.

Automatic and Objective Assessment of Motor Skills Performance in Flexible Bronchoscopy.

Predicting factors of diagnostic yield in electromagnetic navigation bronchoscopy (ENB) have been explored in a number of previous studies based on data from experienced operators. However, little is known about predicting factors when the procedure is carried out by operators in the beginning of their learning curve. We here aim to identify the role of operators' experience as well as lesion- and procedure characteristics on diagnostic yield of ENB procedures in the hands of novice ENB operators. Four operators from three centers without prior ENB experience were enrolled. The outcome of consecutive ENB procedures was assessed and classified as either diagnostic or non-diagnostic and predicting factors of diagnostic yield were assessed. A total of 215 procedures were assessed. A total of 122 (57%) of the ENB procedures resulted in diagnostic biopsies. Diagnostic ENB procedures were associated with a minor yet significant difference in tumor size compared to non-diagnostic/inconclusive ENB procedures (28 mm vs. 24 mm;  = 0.03). Diagnostic ENB procedures were associated with visible lesions at either fluoroscopy ( = 0.003) or radial endobronchial ultrasound (rEBUS), ( = 0.001). In the logistic regression model, lesion visibility on fluoroscopy, but none of operator experience, the presence of a bronchus sign, lesion size, or location nor visibility on rEBUS significantly impacted the diagnostic yield. In novice ENB operators, lesion visibility on fluoroscopy was the only factor found to increase the chance of obtaining a diagnostic sample.

Kristoffer Mazanti Cold

Copenhagen Academy for Medical Education and Simulation (CAMES),
Rigshospitalet,
Copenhagen,
Copenhagen Academy for Medical Education and Simulation (CAMES), Rigshospitalet, Copenhagen

University of Copenhagen and the Capital Region of Denmark

Systematic Bronchoscopy: the Four Landmarks Approach

Systematic Endobronchial Ultrasound - The Six Landmarks Approach

Kristoffer Mazanti Cold

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University of Copenhagen and the Capital Region of Denmark

Systematic Bronchoscopy: the Four Landmarks Approach

Systematic Endobronchial Ultrasound - The Six Landmarks Approach

Copenhagen Academy for Medical Education and Simulation (CAMES),
Rigshospitalet,
Copenhagen,
Copenhagen Academy for Medical Education and Simulation (CAMES), Rigshospitalet, Copenhagen