Muestreo de lesiones mediastínicas subaórticas y paraaórticas mediante broncoscopia robótica asistida con guía por...

Mediastinal sampling of the subaortic - station 5 - and paraaortic - station 6 - lymph nodes and mediastinal lesions traditionally requires surgical access. Image-guided shape-sensing robotic-assisted bronchoscopy (ssRAB) extends endoscopic reach and may offer an alternative sampling approach. We evaluated the feasibility, diagnostic yield, and safety of ssRAB-guided sampling of these anatomically challenging lesions.

All ssRAB procedures performed from October 2019 to September 2025 were reviewed retrospectively. Procedures in which a subaortic or paraaortic mediastinal lesion was targeted were included in the final analysis. Abstracted variables included patient data, pre-operative imaging, procedural details, peri-operative complications, and sampling results. The primary endpoint was conservative diagnostic yield, defined as the rate of procedures establishing a specific diagnosis.

A total of 16 procedures targeting a subaortic or paraaortic mediastinal lesion were identified for the final analysis. The conservative diagnostic yield rate was 69 %. After elimination in one case in which sampling was planned but not pursued, the lenient diagnostic yield rate was 73 %. The conservative diagnostic yield rate was 75 % and 62 % for the subaortic and paraaortic samplings, respectively. One instance of grade 1 pneumothorax was documented. No additional complications were observed.

This single-center retrospective case series demonstrated that image-guided ssRAB may represent a feasible, safe, and minimally invasive approach for sampling subaortic and paraaortic mediastinal lymph nodes and lesions, potentially obviating the need for surgical procedures.