Guide sheath versus non-guide sheath method for endobronchial lesions: a multicentre randomised trial

Oki M, Saka H, Imabayashi T, et al.

Eur Respir J 2022;59:2101678. 10.1183/13993003.01678-2021

What is the key question?

  • Endobronchial Ultrasound Guide Sheath (EBUS-GS) biopsies are used for diagnosis of peripheral lung lesions in combination with radial ultrasound probes. This study considered whether the use of the guide sheath influenced the diagnostic yield of these procedures.

What is the bottom line?

  • The study investigated 605 patients in 8 centres with peripheral lung lesions, randomised to EBUS radial probe biopsy with or without guide sheath. Once the lesion is located, the nature of the procedure requires the removal of the radial probe and the introduction of a biopsy device into the same position. It is not possible to simultaneously obtain the biopsy and image the lesion.
  • There was no difference between groups in terms of position of the lesion in relation to the probe and similar outcomes for diagnosis based on lesion size.

Why read on?

  • This study confirms the long held belief that the use of a guide sheath to allow the passage of a biopsy device back to a lesion is ideal in most cases to optimise yield. Further studies may better define circumstances where lesions may be accessed without the use of the guide sheath.