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Utility of transbronchial lung cryobiopsy with cryoprobe in DPLD

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Authors: Sameer Arbat, Ashok Arbat, Swapnil Bakamwar, Parimal Deshpande, Vinit Niranjane
Publication Date : 2018/9/15
Source: European Respiratory Journal
Volume: 52
Issue: suppl 62
Pages : 211A
Publisher: European Respiratory Society
Description :
Introduction: Transbronchial Lung Cryobiopsy(TBLC) is a relatively new procedure for sampling lung parenchyma. Initial cryobiopsy reports suggest this procedure establishes specific DPLD diagnoses in 70–80% of cases. Our study focuses on current cryobiopsy techniques, diagnostic yield and complication rates.
Aim: To study utility and find out diagnostic yield and safety profile of TBLC.
Methods: Total 30 patients with suspected DPLD or with radiological diagnosis suggestive of DPLD were selected to undergo TBLC. Flexible bronchoscopies were performed in all subjects in the endoscopy suite with the use anesthesia protocol with sedation avoiding full paralysis. TBLC from single lower lobe segment targeting areas of abnormality on pre-procedure CT scan under fluoroscopy guidance was taken. Sample obtained were sent for histopstopathlogical examinations.
Results: Histopathological examination of tissue …

 
 
 

CLINICAL PROFILE OF NONSMOKER PATIENTS WITH COPD

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Authors: S Arbat, A Arbat, B Agrawal, S Bakamwar, P Deshpande
Publication Date : 2019/4/1
Journal : Chest
Volume: 155
Issue: Chest
Pages : 211A
Publisher: Elsevier
Description :
Purpose:
Chronic obstructive pulmonary diseases (COPD), an increasing cause of morbidity and mortality worldwide, has been strongly related to tobacco smoking. While a number of studies have concentrated on smokers, our data demonstrated that many patient of COPD are non-smokers between ages 50-80yrs, and the risk of COPD in non smokers is higher than previously believed. The prevalence of COPD among non-smokers varies widely across region, area and nation.

Methods
This is a retrospective observational study. 180 Non Smoker COPD patients were selected from the year 2016-2018. They were categorized into Mild, Moderate, Severe and Very Severe COPD according to GOLD Guidelines followed by questionnaires.
RESULTS: Out of 180 non-smoker COPD patients, 54% were females. The percentage of mild, moderate severe and very severe patients according to GOLD Guidelines was …
 
 
 

Diagnostic Yield and Safety Profile of Cryobiopsy in Lung Pathologies

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Authors: SA Arbat, A Arbat, S Bakamwar
Publication Date : 2019/5
Book :A72. ADVANCES IN INTERVENTIONAL PULMONARY
Pages : A2357-A2357
Publisher: American Thoracic Society
Description :
Rational:
To study the role and to evaluate safety and diagnostic yield of Cryobiopsy in Diffuse Parenchymal Lung Disease (DPLD), peripheral lesions and endobronchial lesions.

Methods:

It was prospective observational study. All patients suspected DPLD or with peripheral lung lesion on HRCT and all patients with endobronchial lesion on bronchoscopy were selected. Informed consent was taken and those patients willing were subjected to cryobiopsy procedure. Further samples obtained were sent for histopathological analysis. Results obtained from HPE were analyzed.

Results :

Out of 72 patients 21 underwent Trans-Bronchial Lung Cryobiopsy (TBLC) for DPLD, 25 underwent TBLC for peripheral lesions and 26 patients were of endo bronchial lesions that underwent Endobronchial Lung Cryobiopsy (EBLC). The results were as shown in Table 1, 2, 3. Among the 21 patients who underwent TBLC for DPLD, 28 …

 
 
 

ROLE OF RADIAL ENDOBRONCHIAL ULTRASOUND-GUIDED CRYOBIOPSY IN THE DIAGNOSIS OF PERIPHERAL PULMONARY LESIONS: A CASE SERIES

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Authors: Sameer Arbat
Publication Date : 2019/10/1
Journal: Chest
Volume: 156
Issue: 4
Pages : A1061
Publisher: Elsevier
Description :
Purpose:  The diagnosis of peripheral pulmonary lesions (PPLs) may be challenging as they are bronchoscopically invisible. Radial endobronchial ultrasound (EBUS) is useful for accessing PPLs, with the help of TBLB and cryoprobe. Although PPLs can also be accessed with the help of transthoracic ultrasound or Computerised Tomography (CT)-guided Fine Needle Aspiration (FNA), there is a significant risk of pneumothorax.
Methods: This was a retrospective observational study. Patients with PPL on CT-Thorax were subjected for bronchoscopy. Radial EBUS via flexible bronchochoscope with Fluoroscope was used to determine the site and cryobiopsy were taken. Bleeding was controlled by endobronchial balloon placed through a rigid bronchoscope as conduit.
Results: Total 20 patients underwent radial EBUS with fluoroscopy guided cryobiopsy. Histopathological diagnosis was achieved in 17 (85 …

 
 
 

RECANALIZATION OF ENDOBRONCHIAL TUMOR WITH CRYOPROBE AND ELECTROCAUTRY: CASE SERIES

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Authors: Sameer Arbat
Publication Date : 2019/10/1
Journal: Chest
Volume: 156
Issue: 4
Pages : A1084
Publisher: Elsevier
Description :
Purpose :  Endobronchial tumor occluding tracheal or endobronchial lumen is very challenging site for any diagnostic or theauraputic interventions. Recannalising by debulking endobronchial tumor with bronchoscopic cryoprobe & electrocautry is safe procedure and yields good results.
Methods: Eleven consecutive patients with unresectable endobronchial tumour were selected. Efficiency of the procedure was evaluated by pre procedure & post procedure bronchoscopy. Complete removal or partial removal of endobronchial lesion leading to recannalisation was considered successful.
Results : Out of 11 patients 9 (81.82%) were male 2 (18.18) were female. 1 (9.09%) was smokers & 1 (9.09%) was Exsmoker & 9 (81.82%) were nonsmoker. On subsequent histopathological assessment 4 (36.36%) patients had neuroendocrine tumours 2 had adenocarcinoma diagnosis and remaining 5 (18.18%) cases had …

 
 
 

Rare Case of Endobronchial Tumour

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Authors: SA Arbat
Publication Date : 2020/5
Book: D43. INTERVENTIONAL PULMONOLOGY CASE REPORTS: INFECTION, HEMORRHAGE, FOREIGN BODY, AND CANCER
Pages: A6786-A6786
Publisher: American Thoracic Society
Description :
Background and Aims An endobronchial leiomyoma is a rare benign tumor of the bronchial tree. It occurs from the smooth muscle along the tracheo&# 8208; bronchial tree or within the lung parenchyma. It presents less than 2% of all benign lung tumors. To date almost less than 60 cases have been reported in the world literature. In this paper, we present a case report of a rare benign lung tumor in younger individuals. Methods This is a case report of a 39 year old male, non smoker, with no family history of malignancies, presenting with cough and shortness of breath, since 7 months with no resolution despite oral antibiotics. Results Chest radiograph showed hazy density of right lower lung. Plain high resolution computed tomography of the chest, showed Well defined oblong soft tissue mass lesion (3.0 x 1.7) cm in Rt major bronchus compromising central lumen. Patient underwent flexible bronchoscopy which …

 
 
 

Analysis of Endobronchial Ultrasound Guided Trans Bronchial Needle Aspiration Cases at Tertiary Centre in Central India

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Authors: SA Arbat, A Arbat, P Deshpande, S Bakamwar
Publication Date :2020/5
Book: B70. PROGRESS IN NOVEL DIAGNOSTICS AND INTERVENTIONS
Pages:A4185-A4185
Publisher: American Thoracic Society
Description :
Rationale Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a minimally invasive diagnostic test with a high diagnostic yield for suspicious central pulmonary lesions and for mediastinal lymph node staging. EBUS TBNA is the initial sampling modality for any intrathoracic adenopathy.. Study of ultrasonographic features can be used to predict malignant or abnormal lymph nodes. It also guides which lymph nodes to be biopsied to maximize the yield and avoid inconclusive results. It thus gives a guidance regarding further planning in case of inconclusive results. The main objective of this study was to describe the diagnostic yield of EBUS-TBNA for identification of lung cancer.
Methods:
Retrospective study of patients of mediastinal lamphanodopathy≥ 18 years of age undergoing EBUS-TBNA for diagnosis recruited over 12 months. All procedures were performed with a flexible …

 
 
 

Effect of Indoor Air Pollution on Non-Smoker Chronic Obstructive Pulmonary Disease

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Authors:  SA Arbat, I Rahman
Publication Date : 2020/5
Book: A47. HEALTH EFFECTS OF AIR POLLUTION-ORGANIC DUST/BIOMASS
Pages:A1802-A1802
Publisher: American Thoracic Society
Description :

RATIONALE:

Chronic Obstructive Pulmonary Diseases (COPD) is an increasing cause of morbidity and mortality worldwide, and has been strongly related to tobacco smoking. Most studies on COPD have concentrated on smokers. Our data demonstrated that the risk of COPD in non-smokers is higher than previously believed.

METHODS:

 

This is a retrospective observational study. 180 non-smoker COPD patients were selected from the year 2016-2018. History with questionnaire was taken and subsequent spirometry results were evaluated. They were categorized into mild, moderate, severe and very severe COPD according to the GOLD guidelines followed by questionnaires.

RESULTS:

 

Out of 180 non-smoker COPD patients, 54% were females. The percentage of mild, moderate, severe and very severe patients according to the GOLD Guidelines was 26%, 53%, 58% and 43%, respectively. The distribution of …

 
 
 

DIAGNOSTIC YIELD OF LINEAR EBUS: CASE SERIES OF 61 PATIENTS

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Authors: S Arbat, A Arbat, P Deshpande, S Bakamwar
Publication Date : 2020/6/1
Journal: Chest
Volume: 157
Issue: 6
Pages : A247
Publisher: Elsevier
Description :
Purpose
The main objective of this study was to describe the diagnostic yield of EBUS-TBNA for identification of lung cancer.
Methods:
Retrospective study of patients of mediastinal lymphadenopathy≥ 18 years of age undergoing EBUS-TBNA for diagnosis recruited between 17/01/2018 and 10/12/2019. All procedures were performed with Olympus EBUS bronchoscope. Anesthesia in accordance with standard recommendation was given after signing of written consent by the patients before undergoing the procedure. The airway and mediastinal lymph node stations were thoroughly inspected with a flexible bronchoscope. Subsequently, the lymph nodes were identified by radiological imaging study and linear transducer ultrasound. Mediastinal lymph nodes with suspected neoplastic involvement-defined as enlargement, irregular borders, and irregular shape-that was not confirmed by imaging was aspirated …

 
 
 

RARE CASE OF DOUBLE HITCH-STITCH IN A CASE OF TRACHEOESOPHAGEAL FISTULA WITH TRACHEAL AND ESOPHAGEAL STENT: A NOVEL TECHNIQUE

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Authors: S Arbat, A Arbat, P Deshpande, S Bakamwar
Publication Date : 2020/6/1
Journal: Chest
Volume: 157
Issue: 6
Pages : A246
Publisher: Elsevier
Description :
Purpose :
Tracheobronchial airway stents are used to relieve large airway obstruction, fistulas, stenosis in both benign and malignant disease. Caudal migration of tracheal stents can be a significant problem, and can be potentially life threatening by causing distal luminal obstruction. We present a rare case of double hitch-stitch in a case of tracheo esophageal fistula with tracheal and esophageal stent.
Methods:
A 50-year-old male patient presented with cough and dyspnea. Patient was a known case of Ca Esophagus with Esophageal Stent in situ. CT Scan showed tracheoesophageal fistula with esophageal stent migrating into trachea. Tracheal stenting was done with Self Expanding Metallic Stent (SEMS). Patient followed up after one month with recurrent complaints of cough on deglutition. On follow-up bronchoscopy migration of stent was observed. A rare procedure of Double Hitch-Stitch was performed …