TY - JOUR T1 - Endobronchial ultrasound-guided transbronchial biopsy with or without a guide sheath for peripheral pulmonary malignancy JF - ERJ Open Research JO - erjor DO - 10.1183/23120541.00267-2021 VL - 7 IS - 3 SP - 00267-2021 AU - Chun-Ta Huang AU - Lih-Yu Chang AU - Chung-Yu Chen AU - Sheng-Yuan Ruan AU - Ching-Kai Lin AU - Yi-Ju Tsai AU - Chao-Chi Ho AU - Chong-Jen Yu Y1 - 2021/07/01 UR - http://openres.ersjournals.com/content/7/3/00267-2021.abstract N2 - Endobronchial ultrasound (EBUS)-guided transbronchial biopsy (TBB) is a common procedure used to diagnose peripheral pulmonary lesions (PPLs). However, existing literature did not conclusively show a difference in the ability of EBUS-TBB with and without a guide sheath (GS) to diagnose PPLs. This multicenter cohort study enrolled patients presenting for EBUS-TBB of PPLs that finally proved to be malignant. The diagnostic yield and complication rate were compared between patients undergoing EBUS-TBB with and without a GS (EBUS-TBB+GS versus EBUS-TBB−GS). A propensity score matching method was used to balance differences of pertinent clinical features between the two groups. The original cohort consisted of 975 patients (556 in EBUS-TBB−GS; 419 in EBUS-TBB+GS). GS guidance was more likely to be used with smaller (40 mm versus 44 mm) and middle or lower lobe (60% versus 35%) lesions. After propensity score matching, 720 (360 in each group) patients were included; the diagnostic yields for PPLs were 79% and 78% for EBUS-TBB−GS and EBUS-TBB+GS groups, respectively (p=0.649). The complication rates (5.8% versus 7.2% for bleeding; 0.6% versus 1.9% for pneumothorax) appeared to be lower in the EBUS-TBB+GS group, but the differences did not reach statistical significance. The procedure time was significantly longer in the EBUS-TBB+GS group than in the EBUS-TBB−GS group (29 min versus 24 min; p<0.001). In conclusion, adding a GS to EBUS-TBB did not improve the diagnostic yield for malignant PPLs. GS guidance was seemingly associated with a lower number of complications after TBB but contributed significantly to a longer procedure time.In this study, EBUS-guided transbronchial biopsy both with and without a guide sheath provided a similarly favourable diagnostic yield and safety profile for malignant peripheral pulmonary lesions https://bit.ly/3jpi6Kv ER -