Navigational bronchoscopy at a community hospital: clinical and economic outcomes.

Aim: To evaluate the clinical and financial impact of introducing electromagnetic navigation bronchoscopy (ENB) at a community center.

Methods: This retrospective, single-arm, single-center study evaluated 90 consecutive patients who had undergone ENB in 2012. Radial probe endobronchial ultrasound was used to localize the lesion after initial ENB. ENB-aided diagnoses, follow-up procedures and treatments, and adverse events were collected through 2 years.

Results: ENB was conducted for lung biopsy (86 patients), fiducial placement (five), and/or dye marking (two). ENB-aided diagnostic yield was 82.6% (71/86), including 36 malignant and 35 nonmalignant cases. NSCLC was stage I-II in 84.6%. There were four false negatives. Sensitivity and negative predictive value were 90.0 and 88.6%. Pneumothorax occurred in 6/90 (5/6 with chest tube) and minor bleeding in four. The downstream revenue of new ENB cases was US$363,654.

Conclusion: ENB introduction provided high diagnostic yield, early-stage diagnosis, acceptable safety, and was financially justified.