Table of Contents
ISRN Endoscopy
Volume 2013, Article ID 824693, 5 pages
http://dx.doi.org/10.5402/2013/824693
Clinical Study

The Diagnostic Yield of Navigational Bronchoscopy Performed with Propofol Deep Sedation

1Division of Pulmonary and Critical Care Medicine, Stanford University Medical Center, Stanford, CA 94305, USA
2Pulmonary Section, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA 94304, USA
3Palo Alto Medical Foundation, Palo Alto, 701 E. El Camino Real, Mountain View, CA 94040, USA

Received 15 April 2013; Accepted 7 May 2013

Academic Editors: B. Braden and D. Stoyanov

Copyright © 2013 Uma Mohanasundaram et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objective. To describe the diagnostic yield of electromagnetic navigation bronchoscopy (ENB) utilizing propofol for procedural deep sedation. Methods. We conducted a structured retrospective analysis of the medical records of patients who underwent ENB with propofol for the evaluation of pulmonary nodules and masses. We analyzed the relationships between lesion size and location, variance (CT-to-body divergence), and positron emission tomography findings on diagnostic yield. Diagnoses were established by histopathological evaluation and clinical-radiographic followup. Results. 41 patients underwent ENB during the study period. The overall diagnostic yield was 89% (42 of 47 target lesions). Among the 42 positive specimens, the diagnoses were squamous cell carcinoma , adenocarcinoma , small cell carcinoma , adenocarcinoma in situ , coccidioidomycosis , and inflammatory processes . Average lesion size was  cm and variance  mm. The diagnostic yield was greater when the lesion size was >4 cm (100%) and when variance was ≤4 mm (91% versus 87%, ). Conclusion. The diagnostic yield of ENB utilizing propofol for procedural deep sedation at our center was excellent. ENB with deep sedation may result in superior diagnostic yield compared with ENB performed with moderate sedation.