对于亚固体肺结节的机器人辅助支气管镜的诊断有效性和安全性:一个多中心前性观察性研究
Camilla Gomes1, Brandon Cowan1, Mengqi Xiao2
1Department of Surgery, University of California, San Francisco, Calif; Scientific Affairs, Johnson & Johnson MedTech, Santa Clara, Calif.
The Journal of thoracic and cardiovascular surgery
|June 9, 2025
概括
机器人辅助支气管检查 (RAB) 是一种安全有效的工具,用于诊断亚固体结节,包括半固体结节 (SSN) 和地面玻璃结节 (GGN). 这种微创手术证明了这些具有挑战性的肺病变的良好的覆盖范围和诊断产量.
科学领域:
- 肺部病理学 肺部病理学
- 胸部外科手术 胸部外科手术
- 医疗机器人 医疗机器人
背景情况:
- 亚固体结节,包括半固体结节 (SSN) 和地玻璃结节 (GGN),由于其位置和特征,构成诊断挑战.
- 准确和安全的诊断对于适当的患者管理和肺结节的治疗计划至关重要.
研究的目的:
- 评估机器人辅助支气管镜 (RAB) 在亚固体肺结节的诊断中的有效性和安全性.
- 评估关键性能指标,包括SSN和GGN与RAB相关的覆盖范围,诊断产量和并发症率.
主要方法:
- 来自多中心,前性观察性研究的子集分析,涉及患有亚固体结节的患者接受RAB.
- 通过辐射内支气管超声波 (rEBUS) 确认,病变距离,恶性瘤敏感度和诊断产量 (DY) 来衡量有效性.
- 通过记录所有不良事件 (包括肺胸部和出血) 来评估安全性.
主要成果:
- 该研究分析了91名患有亚固体结核的患者 (78名SSN,13名GGN),中位结核大小为18.5毫米,通常位于上叶和外肺三分之一.
- 恶性病发病率为45.1%,主要是腺癌. RAB在81.4%的SSNs和61.5%的GGNs中实现了rEBUS本地化.
- 对恶性瘤的敏感性很高 (77.8%为SSNs,75.0%为GGNs),严格的DY分别为50.0%和61.5%. 肺胸发生在4.4%的病例中.
结论:
- 机器人辅助支气管镜检查 (RAB) 已被证实是对亚固体肺结节的安全和有效的诊断方式.
- 该程序证明了在达到和活检这些具有挑战性的病变的可行性,有助于准确的诊断和管理.
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