ObjectiveTo systematically review the clinical utilization of robotic bronchoscopes in diagnosis of pulmonary nodules, including MonarchTM and IonTM platforms, and then evaluate the efficacy and safety of the procedure. MethodsPubMed, EMbase, Web of Science and Cochrane Central Register of Controlled Trials databases were searched by computer for literature about the biopsy of pulmonary nodules with robotic bronchoscope from January 2018 to February 14, 2022. The quality of research was evaluated with Newcastle-Ottawa Scale. RevMan 5.4 software was used to conduct the meta-analysis. ResultsFinally, 19 clinical studies with 1 542 patients and 1 697 targeted pulmonary nodules were included, of which 13 studies used the IonTM platform and 6 studies used the MonarchTM platform. The overall diagnostic rate of the two systems was 84.96% (95%CI 62.00%-95.00%), sensitivity for malignancy was 81.79% (95%CI 43.00%-96.00%), the mean maximum diameter of the nodules was 16.22 mm (95%CI 10.98-21.47), the mean procedure time was 61.86 min (95%CI 46.18-77.54) and the rate of complications occurred was 4.76% (95%CI 2.00%-15.00%). There was no statistical difference in the outcomes between the two systems. Conclusion Robotic bronchoscope provides a high efficacy and safety in biopsy of pulmonary nodules, and has a broad application prospect for pulmonary nodules diagnosis.
目的 观察右美托咪啶复合丙泊酚靶控静脉麻醉在纤维支气管镜检查术中的麻醉效果。 方法 2010年12月－2012年4月，将60例行纤维支气管镜检查术的患者随机分为丙泊酚麻醉组（对照组）和右美托咪啶复合丙泊酚麻醉组（观察组），每组各30例。观察记录不同时点平均动脉压（MAP）、心率、呼吸次数（RR）、脉搏血氧饱和度（SpO2），镇静评分、手术时间、苏醒时间、丙泊酚总用量、不良反应发生率及患者满意度。 结果 所有患者均能顺利完成操作，诱导入睡后观察组MAP、心率下降（P＜0.05），丙泊酚总用量、不良反应发生率均少于对照组（P＜0.05），镇静评分优于对照组（P＜0.05）；两组RR、SpO2、苏醒时间、手术时间及患者满意度差异无统计学意义（P＞0.05）。 结论 右美托咪定复合丙泊酚靶控输注适用于纤维支气管镜检查术麻醉，是一种更加安全有效的麻醉方法。
Peripheral pulmonary lesions (PPLs) are generally considered as lesions in the peripheral one-third of the lung. A computed tompgraphy (CT) guided transthoracic needle aspiration/biopsy or transbronchial approach using a bronchoscope has been the most generally accepted methods. Navigation technique can effectively improve the diagnosis rate of peripheral pulmonary lesions, reduce the incidence of complications, shorten the time of diagnosis, and make the patients get timely and effective treatment.
The present study was to develop and design a new sonography rigid bronchoscopy and corollary vacuum-assisted biopsy device system with less injury and complication. The system combined ultrasonic-probe with ultrasound catheter, a new medical ultrasound technique, and rigid bronchoscopy (RB) which is improved with an auxiliary vacuum-assisted biopsy device. The principle of the device is vacuum suction and rotary knife. The reduced outer diameter of the RB led to less pain and lower complications for the patient. With the help of ultrasonic-probe (30 MHz), lesions and blood vessels can be identified clearly and unintentional puncture and damage to blood vessels can be avoided. Plenty of lesions can be obtained quickly through the vacuum-assisted biopsy device without getting puncture needle in and out repeatedly. The novel endobronchial sonography rigid bronchoscopy and matched vacuum-assisted biopsy device has many remarkable advantages. It can enlarge the applied range of the RB from endobronchial to mediastinal lesions, avoiding unintentional puncture of vessels. Obtaining multiple samples with a higher accuracy rate than that by other sampling techniques, minimizing operation time, alleviating pain and decreasing the complication rate, the system makes up the technical deficiency for the diagnosis and treatment of the mediastinal lesions, to a certain degree.