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Severe Chronic Obstructive Pulmonary Disease Is Not Associated With Complications After Navigational Bronchoscopy Procedures.

Severe Chronic Obstructive Pulmonary Disease Is Not Associated With Complications After Navigational Bronchoscopy Procedures.
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Towe CW, Ho VP, Kazakov J, Jackson T, Perry Y, Argote-Greene LM, Ginsberg JP, Linden PA,


Towe CW, Ho VP, Kazakov J, Jackson T, Perry Y, Argote-Greene LM, Ginsberg JP, Linden PA, (click to view)

Towe CW, Ho VP, Kazakov J, Jackson T, Perry Y, Argote-Greene LM, Ginsberg JP, Linden PA,

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The Annals of thoracic surgery 2017 04 12() pii S0003-4975(17)30160-1
Abstract
BACKGROUND
Electromagnetic navigational bronchoscopy (ENB) is a commonly used technique to obtain biopsies of peripheral pulmonary lesions. Little is known about risk factors for complications with this procedure. The aim of this study was to assess the complication rate associated with ENB and the relationship of complications to patient- and procedure-related factors.

METHODS
Consecutive ENB procedures at an academic medical center between May 11, 2011, and September 11, 2015, were reviewed retrospectively. Preoperative characteristics, including pulmonary function, procedure characteristics, and the occurrence of complications, were recorded.

RESULTS
In all, 361 procedures were performed on 341 patients. Complications occurred in 30 of 361 (8.3%), the most common of which was pneumothorax (27, 7.5%). Complications were not related to age, sex, American Society of Anesthesiologists grade, or pulmonary function test result. Patients with complications had longer procedure times (50 versus 73 minutes, p = 0.03), and had more interventional modalities used (2.4 versus 3.2, p = 0.001). Multiple logistic regression demonstrated that bronchoalveolar lavage was significantly associated with complications (odds ratio 6.40; 95% confidence interval: 1.68 to 24.3, p = 0.006).

CONCLUSIONS
Electromagnetic navigational bronchoscopy is safe, and the rate of complications is not elevated among patients with poor lung function. Bronchoalveolar lavage performed during ENB was associated with elevated risk of complications and should be studied further.

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