Literature Archives

Bronchoscopic intervention remains critical for rapid relief of malignant central airway obstruction compared to slower-acting radiation therapy.

Highlights the critical collaboration between interventional pulmonologists and thoracic surgeons for precise localization of small nodules prior to sublobar resection.

Reinforces essential procedural skills for thoracentesis, chest tube placement, and pleural interventions.

Dynamic Cell Imaging is a feasible point-of-care tool for interventional pulmonologists that shows high concordance with final pathology, achieving an overall biopsy-level concordance of 84% (95% CI: 77% to 90%), particularly when paired with cryobiopsies and forceps biopsies.

The VSTAT instruments provide a reliable and objective method for assessing BLVR competency, demonstrating significant score increases across experience tiers (P < 0.001) that should be integrated into training and credentialing pathways.

Endobronchial oxymetazoline is associated with a mild increase in blood pressure and a decrease in heart rate, including a statistically significant increase in bradycardia (OR 1.92, 95% CI 1.09 to 3.40, P = 0.024), but it appears safe and well-tolerated without increasing the need for rescue medications.

Although overall diagnostic yield did not differ significantly between the groups, the 22-gauge fine needle biopsy yielded a significantly higher rate of adequate histologic tissue (98.6% versus 86.7%, P < 0.001) and larger core samples, making it a valuable tool when tissue architecture preservation is needed.

Pleural fluid IL-9 levels were significantly higher in tuberculous pleural effusion than in malignant effusion, achieving an AUC of 0.987 with 98.0% sensitivity and 92.59% specificity at a cutoff of 748.47 ng/L (P < 0.001), outperforming traditional markers like ADA and CEA and offering a promising new adjunctive diagnostic tool for IP practice.

Relevant to the timing and diagnostic strategies utilized in bronchoscopic evaluation of screen-detected lung cancer.

Highlights the translational challenges in bronchoscopic airway disease treatments and clinical trial design.

Adopting advanced navigational platforms and tissue-acquisition tools significantly improves diagnostic yields—such as an increase from 57% with ENB to 72% with ssRAB (RR = 1.26, 95% CI 1.09–1.45, P < 0.001)—even when tackling smaller, more challenging lesions. However, clinicians must carefully weigh these gains against higher procedural radiation and pneumothorax risks.

For interventional pulmonologists, these guidelines show that routine confirmatory mediastinoscopy can be safely omitted after a negative CP-EBUS, as pooled analysis demonstrated no significant difference in missed N2 or N3 disease compared to CP-EBUS alone with an RD of 0.03 (-0.03 to 0.09, P = 0.18). Furthermore, CP-EBUS should be prioritized for peripheral tumors greater than 3 cm due to a significantly higher risk of occult N2 disease (RD 0.06, 0.04 to 0.07, P = 0.0016), while invasive staging can be bypassed for pure ground-glass nodules.