Establishment of minimally invasive, safe, and reliable bronchoscopy by various devices and anesthesia methods

2021 Fiscal Year Final Research Report

• Project/Area Number: 19K16966
• Research Category: Grant-in-Aid for Early-Career Scientists
• Allocation Type: Multi-year Fund
• Review Section: Basic Section 52010:General internal medicine-related
• Research Institution: National Cancer Center Japan (2021); University of Occupational and Environmental Health, Japan (2019-2020)
• Principal Investigator: Uchimura Keigo 国立研究開発法人国立がん研究センター, 中央病院, 医員 (00822553)
• Project Period (FY): 2019-04-01 – 2022-03-31
• Keywords: 気管支鏡 / 超音波内視鏡 / 肺癌 / 麻酔 / EBUS

Outline of Final Research Achievements

We analyzed elastographic images of hilar and mediastinal lymph nodes without significant enlargement on CT, which may contribute to the diagnostic yield of endobronchial ultrasound-guided transbronchial needle aspiration(EBUS-TBNA), and found that even in lymph nodes without significant enlargement on CT, elastographic findings had a negative predictive value of more than 90%, suggesting that elastography may be a useful tool in the diagnosis. We had a presentation at a conference and our original paper was accepted for publication in an international journal. In order to minimize patient distress during bronchoscopy, it is necessary to use sedatives in combination with medical narcotics. In this study, it was considered that bronchoscopy could be performed as safely in patients over 75 years old as in those under 75 years old, if the indications for bronchoscopy were determined, including the patient's general condition.

Free Research Field

気管支鏡

Academic Significance and Societal Importance of the Research Achievements

超音波気管支鏡ガイド下針生検は多くの施設で局所麻酔下に行われるが、しばしば検査時間の長さが適切な検体採取を妨げる。リアルタイムに検査中にエラストグラフィ画像を評価し、対象リンパ節が悪性もしくは良性であるかを検討しながら、処置を行うことで、効率的な検体採取が可能になると考えられる。また、近年日本も高齢化が進んでいるが、本研究に75歳以上であっても75歳未満同様に鎮静薬と鎮咳薬の併用を行っても安全に気管支鏡検査が行えることが証明された。本研究は、低侵襲で安全かつ確実な気管支鏡検査法の確立に寄与することができたと考えられる。