Yield of Navigational Ultrathin Bronchoscopy with Fluoroscopy in Diagnosis of Pulmonary Nodules

Background: Although many of the tiny lesions found on simple chest radiography are benign, CT finds more PPLs than radiography. Thus, it is essential to be able to differentiate benign lesions from lung cancer using a safer and more reliable technique for diagnosis to prevent needless surgical treatments.Aim of the work: To assess the value of the navigational bronchoscopy with ultrathin bronchoscope and x-ray fluoroscopy in diagnosing peripheral pulmonary lesions.Patients and Methods: Forty patients with peripheral pulmonary lesions underwent lung point navigational bronchoscopy using an ultrathin bronchoscope and X-ray fluoroscopy in the bronchoscopy unit of the military Kobri Al Kobba chest hospital.Results: Lung point navigational bronchoscopy successfully diagnosed 36 cases (90%), while 4 cases were undiagnosed (10%). The majority of the studied lesions were malignant in 24 cases (60%), carcinoid tumors in 4 cases (10%), and benign and undiagnosed lesions in 8 and 4 cases (20%, 10%), respectively. Regarding the site of diagnosed nodules, 12 (33.3%) of them were in the right upper lobe, 2 (6.5%) right lower lobe, 6 (16.7%) left upper lobe, 8 (22.2%) left lower lobe, 2 (6.5%) right upper and lower lobes, 2 (5.6%) right upper, middle & lower lobes, 4 (11.1%) right &left lower lobes. While undiagnosed nodules, 2 (5%) from each left lower and right lower lobes.Conclusion: Lung point navigational bronchoscopy-guided ultrathin bronchoscopy under x-ray fluoroscopy is a safe and effective maneuver for obtaining samples of peripheral lung lesions.