The contribution of widely used devices in the diagnosis of peripheral pulmonary lesions in patients presenting with respiratory distress

PURPOSE: We retrospectively reviewed the contribution of widely used devices such as the standard fiberoptic bronchoscope in the diagnosis of peripheral pulmonary lesions (PPLs) in patients who presented with respiratory distress. SUBJECT: We performed bronchoscopy for 106 PPLs in January-December 2007, and diagnosed access to the lesions to be difficult. METHOD: For these lesions, we applied Sasada transbronchial angled forceps (STAF), transbronchial needle aspiration cytology (TBAC), thin bronchoscopy, and ultra-thin bronchoscopy, which are widely used devices, after routinely performing biopsy with standard forceps and saved each specimen separately, and finally compared the pathological diagnosis. RESULTS: The diagnostic yield obtained with specimens using standard forceps was 36.8%; however, the overall diagnosis was improved to 70.8% after we used these other devices and methods. We achieved diagnosis with STAF (10 lesions), followed by thin bronchoscopy (5 lesions), and ultra-thin bronchoscopy (14 lesions). No diagnosis was made by TBAC. CONCLUSION: We conclude that these widely employed devices can contribute to improvements in the diagnosis of cases of respiratory distress in which arrival to the lesions is difficult.