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1、CHESTSpecialFeaturesPULMONARYPROCEDURESLatestAdvancesinAdvancedDiagnosticandTherapeuticPulmonaryProceduresGerardA.Silvestri,MD,FCCP;DavidFeller-Kopman,MD,FCCP;AlexanderChen,MD;MomenWahidi,MD,FCCP;KazuhiroYasufuku,MD,PhD,FCCP;andArminErnst,MD,MHCM,FCCPOverthepast15years,patientswit
2、hamyriadofpulmonaryconditionshavebeendiagnosedandtreatedwithnewtechnologiesdevelopedforthepulmonarycommunity.Advanceddiagnosticandtherapeuticproceduresonceperformedinanoperatingtheaterundergeneralanesthesiaarenowroutinelyperformedinabronchoscopysuiteundermoderatesedationwithclinic
3、allymeaningfulimprovementsinoutcome.Withtheminiaturizationofscopesandinstruments,improve-mentsinoptics,andcreativeengineers,ahostofnewdeviceshasbecomeavailableforclinicaltestinganduse.Agrowingcommunityofpulmonologistsisdoingcomparativeeffectivenesstrialsthattestnewtechnologiesagai
4、nstthecurrentstandardofcare.Whilemoreresearchisneeded,itseemsreasonabletoprovideanoverviewofpulmonaryproceduresthatareinvariousstagesofdevelopment,testing,andpracticeatthistime.Fiveareasarecovered:navigationalbronchos-copy,endobronchialultrasound,endoscopiclungvolumereduction,bron
5、chialthermoplasty,andpleuralprocedure.Appropriatetrainingforclinicianswhowishtoprovidetheseserviceswillbecomeanareaofintensescrutinyasnewskillswillneedtobeacquiredtoensurepatientsafetyandagoodclinicalresult.CHEST2012;142(6):1636–1644Abbreviations:6MWT56-minwalktest;BT5bronchialthe
6、rmoplasty;CP-EBUS5convexprobeendobronchialultrasound;EBUS-TBNA5endobronchialultrasound-transbronchialneedleaspiration;ENB5electromagneticnavigationalbronchoscopy;EUS-FNA5endoscopicultrasound-guidedfine-needleaspiration;LVR5lungvolumereduction;MPE5malignantpleuraleffusion;NSCLC5non-
7、smallcelllungcancer;RP-EBUS5radialprobeendobron-chial;SGRQ5St.George’sRespiratoryQuestionnaire;TPC5tunneledpleuralcatheter;TTNA5transthoracicneedleaspirationTherehasbeenanexplosioninpulmonaryproce-outpatientsetting.Malignantpleuraleffusionwasaduretechnologyoverthepast10years.Asrec
8、entlyvexingproblemthatleftpatient
