随着计算机断层扫描在肺癌筛查和其他癌症监测中的越来越广泛使用，胸外科医生正在接到需要肺部病变活检的患者的介绍。电磁导航支气管镜引导的肺活检是一种相对较新的支气管镜检查技术。我们的目的是评估电磁导航支气管镜引导的肺活检的诊断收益和安全性。我们对接受胸外科医疗服务所进行的电磁导航支气管镜活检的患者进行了回顾性研究，并评估了该技术的安全性和诊断精度。总共有110名患者（男性46人，女性64人）接受了电磁导航支气管镜对肺部病变（n = 121，中位数为27毫米，四分位数为17-37毫米）的取样。没有手术相关的死亡。有4名患者（3.5％）需要进行穿刺引流治疗的气胸。93个（76.9％）病变是恶性的。 121个病变中有87个（71.9％）确诊。其准确率随着病变大小的增加而增加（P = .0578），小于2厘米的病变的诊断率为50％，而大于等于2厘米的病变的诊断率为81％。表现出阳性"支气管征"的病变的诊断率为87％（45/52），而"支气管征"为阴性的病变的诊断率为61％（42/69）（P = .0359）。胸外科医生可以安全地进行电磁导航支气管镜活检，并具有良好的诊断收益和最小的术后并发症。准确性随着"支气管征"的出现和病变大小的增加而增加。对于具有较大肿瘤和支气管征的患者可以采用这种方法进行活检。需要进一步研究以定义电磁导航支气管镜在肺部病变诊断中的角色。Copyright © 2022 Elsevier Inc. All rights reserved.

With the increasing use of computed tomography scans for lung cancer screening and surveillance of other cancers, thoracic surgeons are being referred patients with lung lesions for biopsies. Electromagnetic navigational bronchoscopy-guided lung biopsy is a relatively new technique for bronchoscopic biopsy. Our objective was to evaluate the diagnostic yields and safety of electromagnetic navigational bronchoscopy-guided lung biopsy.We conducted a retrospective review of patients who underwent an electromagnetic navigational bronchoscopy biopsy, performed by a thoracic surgical service, and evaluated its safety and diagnostic accuracy.In total, 110 patients (men 46, women 64) underwent electromagnetic navigational bronchoscopy sampling of pulmonary lesions (n = 121; median size 27 mm; interquartile range 17-37 mm). There was no procedure-related mortality. Pneumothorax requiring pigtail drainage occurred in 4 patients (3.5%). Ninety-three (76.9%) of the lesions were malignant. Eighty-seven (71.9%) of the 121 lesions had an accurate diagnosis. Accuracy increased with increased lesion size (P = .0578) with a yield of 50% for lesions <2 cm, increasing to 81% for lesions ≥2 cm. The lesions that demonstrated a positive "bronchus sign" had a yield of 87% (45/52) compared with 61% (42/69) in lesions with a negative "bronchus sign" (P = .0359).Thoracic surgeons can perform electromagnetic navigational bronchoscopy safely, with minimal morbidity and with good diagnostic yields. Accuracy increases with the presence of a bronchus sign and increasing lesion size. Patients with larger tumors and the bronchus sign may be candidates for this approach to biopsy. Further work is required to define the role of electromagnetic navigational bronchoscopy in the diagnosis of pulmonary lesions.Copyright © 2022 Elsevier Inc. All rights reserved.