Bilan des nodules pulmonaires périphériques. Ce que peut apporter la voie endobronchique

Current flexible bronchoscopy cannot explore distal airways over 6th order. The diagnosis of peripheral nodules is thus limited with a sensibility of 30% for nodules less than 2 cm. Up to now, the trans thoracic needle aspiration (TTNA) under CT scan guidance is the gold standard but some limitations exist with a high risk of pneumothorax. New ultrathin bronchoscopes and techniques of virtual guidance, radial echo miniprobe or electromagnetic navigation offer new perspectives. Published results give encouraging data, similar to TTNA sensibility without pneumothorax risk. However, the diffusion of these new methods remains confidential. A significant increase of this option could be predicted but required a limitation of the device costs.