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The Role of Interventional Pulmonology in Respiratory Diseases: From Diagnosis to Treatment

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A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Pulmonology".

Deadline for manuscript submissions: closed (20 June 2023) | Viewed by 6881

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Special Issue Editors

Dr. Daniel Peter Franzen

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Guest Editor

1. Department of Internal Medicine, Spital Uster, Uster, Switzerland
2. Department of Pulmonology, University Hospital Zurich, Zurich, Switzerland
Interests: interventional pulmonology (particularly bronchoscopic lung volume reduction, tracheoplasty, and airway stenting); intensive care medicine; pulmonary infections

Dr. Filiz Oezkan

E-Mail Website
Co-Guest Editor

Department of Pulmonary Medicine, Section of Interventional Pneumology, Ruhrlandklinik-University Hospital Essen, University of Duisburg-Essen, Essen, Germany
Interests: all aspects of IP; translational lung cancer research; women in interventional pulmonology

Special Issue Information

Dear Colleagues,

Interventional pulmonology has become an indispensable, highly evolving, medical field for diagnosis and treatment of various lung diseases. Originating from traditional flexible and rigid bronchoscopy, the combination with advanced techniques such as confocal laserendomicroscopy, endosonography, electromagnetic navigation, radiofrequency ablation, cryothermia, and others is key to the growth of diagnostic and treatment approaches in this minimally invasive field.

We are pleased to present the current Special Issue on the role of interventional pulmonology in respiratory diseases, covering topics from diagnosis to treatment and providing insights into different aspects of interventional pulmonology with a mix of original and review articles.

All papers submitted to this Special Issue are reviewed by independent referees, and the final decision is made by a JCM Editorial Board Member who does not have any conflicts of interest with the submission.

Dr. Daniel Peter Franzen
Dr. Filiz Oezkan
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

pulmonary emphysema
lung cancer
interstitial lung disease
EBUS
asthma
chronic bronchitis
airway stenosis

Published Papers (6 papers)

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10 pages, 1777 KiB

Open AccessArticle

One-Lung Ventilation during Rigid Bronchoscopy Using a Single-Lumen Endotracheal Tube: A Descriptive, Retrospective Single-Center Study

by Carolin Steinack, Helene Balmer, Silvia Ulrich, Thomas Gaisl and Daniel P. Franzen

J. Clin. Med. 2023, 12(6), 2426; https://doi.org/10.3390/jcm12062426 - 21 Mar 2023

Cited by 1 | Viewed by 1271

Abstract

Using one-lung ventilation (OLV) through a single-lumen endotracheal tube (SLT) in the untreated lung during rigid bronchoscopy (RB) and jet ventilation, high oxygenation can be guaranteed, whilst procedures requiring thermal energy in the other lung are still able to be used. This pilot study aimed to examine the bronchoscopy-associated risks and feasibility of OLV using an SLT during RB in patients with malignant airway stenosis. All consecutive adult patients with endobronchial malignant lesions receiving OLV during RB from 1 January 2017 to 12 May 2021 were included. We assessed perioperative complications in 25 RBs requiring OLV. Bleeding grades 1, 2, and 3 complicated the procedure in two (8%), five (20%), and five (20%) patients, respectively. The median saturation of peripheral oxygen remained at 94% (p = 0.09), whilst the median oxygen supply did not increase significantly from 0 L/min to 2 L/min (p = 0.10) within three days after the bronchoscopy. The 30-day survival rate of the patients was 79.1% (95% CI 58.4–91.1%), all of whom reported an improvement in subjective well-being after the bronchoscopy. OLV using an SLT during RB could be a new treatment approach for endobronchial ablative procedures without increasing bronchoscopy-associated risks, allowing concurrent high-energy treatments. Full article

(This article belongs to the Special Issue The Role of Interventional Pulmonology in Respiratory Diseases: From Diagnosis to Treatment)

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4 pages, 1249 KiB

Open AccessCommunication

Only EBUS-Guided Mediastinal Lymph Node Cryobiopsy Enabled Immunotherapy in a Patient with Non-Small Cell Lung Cancer

by Jürgen Hetzel, Laetitia A. Mauti, Jonas Winkler, Sabine Cardoso Almeida, Philip Jermann, Miklos Pless, Lukas Bubendorf, Peter Karl Bode and Maik Häntschel

J. Clin. Med. 2023, 12(6), 2355; https://doi.org/10.3390/jcm12062355 - 17 Mar 2023

Cited by 1 | Viewed by 1541

Abstract

Personalized treatment of metastatic non-squamous non-small cell lung cancer (NSCLC) requires detailed molecular characterization of the tumour including detection of predictive driver mutations and programmed death ligand 1 (PD-L1) expression. Complete detection is influenced by the amount of tumour cells sampled as well as their quality. Different sampling techniques may be necessary to provide sufficient tumour material for comprehensive molecular characterization. Missing the detection of targetable molecular genetic aberrations would have a serious impact on the quality of life and prognosis of a patient. This case report highlights the importance of biopsy technique in a patient with NSCLC. Several procedures—pleural puncture, transthoracic lung biopsy and endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA)—could not provide sufficient tumour material for precise tumour characterization. Only the addition of EBUS-guided transbronchial lymph node cryobiopsy (EBUS-TBLNC) enabled complete immunohistochemical and genetic tumour characterization, demonstrating PD-L1 expression in 100% of the tumour cells in the absence of actionable genetic alterations. Based on these results, immunotherapy was initiated. Full article

(This article belongs to the Special Issue The Role of Interventional Pulmonology in Respiratory Diseases: From Diagnosis to Treatment)

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10 pages, 892 KiB

Open AccessArticle

Lung Ultrasound for the Exclusion of Pneumothorax after Interventional Bronchoscopies—A Retrospective Study

by Melanie Scarlett Mangold, Fabienne Rüber, Carolin Steinack, Fiorenza Gautschi, Jasmin Wani, Sascha Grimaldi and Daniel Peter Franzen

J. Clin. Med. 2023, 12(4), 1474; https://doi.org/10.3390/jcm12041474 - 12 Feb 2023

Viewed by 1594

Abstract

A chest X-ray (CXR) is recommended after bronchoscopies with an increased risk of pneumothorax (PTX). However, concerns regarding radiation exposure, expenses and staff requirements exist. A lung ultrasound (LUS) is a promising alternative for the detection of PTX, though data are scarce. This study aims to investigate the diagnostic yield of LUS compared to CXR, to exclude PTX after bronchoscopies with increased risk. This retrospective single-centre study included transbronchial forceps biopsies, transbronchial lung cryobiopsies and endobronchial valve treatments. Post-interventional PTX screening consisted of immediate LUS and CXR within two hours. In total, 271 patients were included. Early PTX incidence was 3.3%. Sensitivity, specificity, and the positive and negative predictive values of LUS were 67.7% (95% CI 29.93–92.51%), 99.2% (95% CI 97.27–99.91%), 75.0% (95% CI 41.16–92.79%) and 98.9% (95% CI 97.18–99.54%), respectively. PTX detection by LUS enabled the immediate placement of two pleural drains along with the bronchoscopy. With CXR, three false-positives and one false-negative were observed; the latter evolved into a tension-PTX. LUS correctly diagnosed these cases. Despite low sensitivity, LUS enables early diagnosis of PTX, thus preventing treatment delays. We recommend immediate LUS, in addition to LUS or CXR after two to four hours and monitoring for signs and symptoms. Prospective studies with higher sample sizes are needed. Full article

(This article belongs to the Special Issue The Role of Interventional Pulmonology in Respiratory Diseases: From Diagnosis to Treatment)

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10 pages, 1333 KiB

Open AccessArticle

Transesophageal Endoscopic Ultrasound Fine Needle Biopsy for the Diagnosis of Mediastinal Masses: A Retrospective Real-World Analysis

by Daniela Assisi, Filippo Tommaso Gallina, Daniele Forcella, Riccardo Tajè, Enrico Melis, Paolo Visca, Federico Pierconti, Emanuela Venti and Francesco Facciolo

J. Clin. Med. 2022, 11(18), 5469; https://doi.org/10.3390/jcm11185469 - 17 Sep 2022

Cited by 3 | Viewed by 2113

Abstract

Background: Endoscopic ultrasound (EUS) plays an important role in the diagnosis and staging of thoracic disease. Our report studies the diagnostic performance and clinical impact of EUS fine needle aspiration (FNA) in a homogenous cohort of patients according to the distribution of the enlarged MLNs or pulmonary masses. Methods: We retrospectively reviewed the diagnostic performance of 211 EUS-FNA in 200 consecutive patients with enlarged or PET-positive MLNs and para-mediastinal masses who were referred to our oncological center between January 2019 and May 2020. Results: The overall sensitivity of EUS-FNA was 85% with a corresponding negative predictive value (NPV) of 56% and an accuracy of 87.5%. The sensitivity and accuracy in patients with abnormal MLNs were 81.1% and 84.4%, respectively. In those with para-mediastinal masses, sensitivity and accuracy were 96.4% and 96.8%. The accuracy for both masses and lymph nodes was 100%, and in the LAG (left adrenal gland), it was 66.6%. Conclusions: Our results show that, in patients with suspected mediastinal masses, EUS-FNA is an accurate technique to evaluate all reachable mediastinal nodal stations, including station 5. Full article

(This article belongs to the Special Issue The Role of Interventional Pulmonology in Respiratory Diseases: From Diagnosis to Treatment)

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10 pages, 627 KiB

Open AccessArticle

Endobronchial Ultrasound-Guided Transbronchial Forceps Biopsy: A Retrospective Bicentric Study Using the Olympus 1.5 mm Mini-Forceps

by Fabienne Rüber, Gilles Wiederkehr, Carolin Steinack, Sylvia Höller, Peter Karl Bode, Fabian Kölbener and Daniel Peter Franzen

J. Clin. Med. 2022, 11(16), 4700; https://doi.org/10.3390/jcm11164700 - 11 Aug 2022

Cited by 2 | Viewed by 1566

Abstract

When evaluating mediastinal/hilar lymphadenopathy (LAD) or masses, guidelines recommend endobronchial ultrasound (EBUS)-guided transbronchial needle aspiration (TBNA) as an initial technique for tissue analysis and diagnosis. However, owing to the small sample size obtained by needle aspiration, its diagnostic yield (DY) is limited. EBUS transbronchial forceps biopsy (TBFB) used as a complimentary technique to EBUS-TBNA might allow for better histopathological evaluation, thus improving DY. In this retrospective bicentric study, we assessed the DY and safety of an EBUS-guided 1.5 mm mini-forceps biopsy combined with EBUS-TBNA for the diagnosis of mediastinal/hilar LAD or masses compared to EBUS-TBNA alone. In total, 105 patients were enrolled. The overall DY was 61.9% and 85.7% for TBNA alone and EBUS-TBNA combined with EBUS-TBFB, respectively (p < 0.001). While the combined approach was associated with a significantly higher DY for lung cancer diagnosis (97.1% vs. 76.5%, p = 0.016) and sarcoidosis (85.2% vs. 44.4%, p = 0.001), no significant differences in DY were calculated for subgroups with smaller sample sizes such as lymphoma. No major adverse events were observed. Using a 1.5 mm mini-forceps is a safe and feasible technique for biopsy of mediastinal or hilar LAD or masses with superior overall DY compared to EBUS-TBNA as a standalone technique. Full article

(This article belongs to the Special Issue The Role of Interventional Pulmonology in Respiratory Diseases: From Diagnosis to Treatment)

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Other

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11 pages, 1182 KiB

Open AccessBrief Report

Modern Bronchoscopic Treatment Options for Patients with Chronic Bronchitis

by Anna Katharina Mayr and Arschang Valipour

J. Clin. Med. 2023, 12(5), 1854; https://doi.org/10.3390/jcm12051854 - 26 Feb 2023

Cited by 2 | Viewed by 2186

Abstract

Chronic Obstructive Pulmonary Disease (COPD) is one of the leading causes of death worldwide and has a large impact on a patient’s quality of life due to its wide range of symptoms and comorbidities. There are known to be different phenotypes in COPD with various extents on the burden of the disease and its prognosis. Chronic bronchitis with persistent cough and mucus production is regarded as one of the main symptoms of COPD with tremendous effects on subjectively reported symptom burden and frequency of exacerbations. Exacerbations in turn are known to have an impact on disease progression and increase health care costs. Modern bronchoscopic treatment options are currently under investigation targeting the problem of chronic bronchitis and frequent exacerbations. This review summarizes the existing literature about these modern interventional treatment options and provides perspectives on upcoming studies. Full article

(This article belongs to the Special Issue The Role of Interventional Pulmonology in Respiratory Diseases: From Diagnosis to Treatment)

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