ArticleRespirology (Carlton, Vic.)2025
Feasibility of a Modified Bronchoscopic Transparenchymal Nodule Access Technique ('Essen Tunnel') for Improving the Diagnosis of Intraparenchymal Pulmonary Lesions.
Article in Respirology (Carlton, Vic.), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Transbronchial Access of Solitary Pulmonary Nodules Without Bronchus Sign Using a Novel Puncture Dilatation Catheter: Initial Feasibility Experience.Respirology case reports · 2026Article
- Annual progress in transbronchial diagnosis and treatment of pulmonary malignant tumors [2025]: a narrative review.Translational lung cancer research · 2026Review
- Surgical Process Modeling of Workflow and Performance in Image-Guided Bronchoscopy.Annals of biomedical engineering · 2025Article
- Feasibility of a Modified Bronchoscopic Transparenchymal Nodule Access Technique ('Essen Tunnel') for Improving the Diagnosis of Intraparenchymal Pulmonary Lesions.Respirology (Carlton, Vic.) · 2025Article
Corrections and comments
- Erratum issued
Authors and funding
8 authors.
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Abstract
BACKGROUND AND
objectiveDiagnosing intraparenchymal pulmonary lesions lacking a bronchus sign remains challenging. Bronchoscopic transparenchymal nodule access (BTPNA) for reaching such lesions has seen limited clinical adoption due to insufficient evidence and practical challenges. This study evaluates the feasibility and diagnostic yield of a modified BTPNA (mBTPNA) technique-referred to as the 'Essen tunnel'-which eliminates the need for a guide sheath.
methodsA retrospective analysis was conducted on patients undergoing virtual bronchoscopic navigation (VBN) incorporating the mBTPNA technique at our centre, from December 2019 to March 2024. The 'Essen tunnel' was created by a needle under virtual navigation guidance, enabling direct insertion of an ultrathin bronchoscope (UTB) or radial endobronchial ultrasound (R-EBUS) probe to biopsy intraparechymal lesions.
resultsAmong 266 lesions targeted via VBN, 37 (14%) intraparenchymal lesions (mean target length: 12.7 ± 4.1 mm) were accessed using mBTPNA. The tunnel was successfully created in 97.3% of cases with UTB intubation in 51.4%. R-EBUS was inserted into the tunnel in 83.8% of cases. Semicircular to circular patterns (SCP) were detected in 19.4% before and 61.3% after tunnel creation (p < 0.01). SCP presence on R-EBUS following mBTPNA was associated with a diagnostic accuracy of 66.7%, comparable to that observed in non-tunnel lesions exhibiting a bronchus sign (72.9%, p = 0.58). No severe complications were observed.
conclusionThe mBTPNA technique is a feasible and safe method that enhances endosonographic lesion detection and achieves promising diagnostic accuracy for challenging intraparenchymal lesions.
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