BACKGROUND The Robotic Endoscopic System (Auris Health, Inc., Redwood City, CA) has the potential to overcome several limitations of contemporary guided-bronchoscopic technologies for the diagnosis of lung lesions. Our objective is to report on the initial post-marketing feasibility, safety and diagnostic yield of this technology. METHODS We retrospectively reviewed data on consecutive cases in which robot-assisted bronchoscopy was used to sample lung lesions at four centers in the US (academic and community) from June 15th, 2018 to December 15th, 2018. RESULTS One hundred and sixty-seven lesions in 165 patients were included in the analysis, with an average follow-up of 185 ± 55 days. The average size of target lesions was 25.0 ± 15.0 mm. Seventy-one percent were located in the peripheral third of the lung. Pneumothorax and airway bleeding occurred in 3.6 and 2.4% cases, respectively. Navigation was successful in 88.6% of cases. Tissue samples were successfully obtained in 98.8%. The diagnostic yield estimates ranged from 69.1 to 77% assuming the cases of biopsy-proven inflammation without any follow-up information (N = 13) were non-diagnostic and diagnostic, respectively. The yield was 81.5, 71.7 and 26.9% for concentric, eccentric and absent r-EBUS views, respectively. Diagnostic yield was not affected by lesion size, density, lobar location or centrality. CONCLUSIONS RAB implementation in community and academic centers is safe and feasible, with an initial diagnostic yield of 69.1-77% in patients with lung lesions that require diagnostic bronchoscopy. Comparative trials with the existing bronchoscopic technologies are needed to determine cost-effectiveness of this technology.

中文翻译：

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机器人辅助的支气管镜诊断肺部病变：最初的多中心经验的结果。

背景技术机器人内窥镜系统（Auris Health，Inc.，Redwood City，CA）具有克服现代引导支气管镜技术诊断肺部病变的若干限制的潜力。我们的目标是报告此技术的初步上市后可行性，安全性和诊断收益。方法我们回顾性研究了自2018年6月15日至2018年12月15日在美国四个中心（学术和社区）使用机器人辅助支气管镜对肺部病变进行采样的连续病例的数据。结果167处病变该研究纳入了165名患者，平均随访时间为185±55天。目标病变的平均大小为25.0±15.0 mm。71％位于肺的外围三分之一。气胸和气道出血分别发生在3.6％和2.4％的病例中。导航成功的案例为88.6％。组织样本成功获得98.8％。假设经活检证实为炎症且无任何随访信息的病例（N = 13）分别为非诊断性和诊断性，则诊断产率估计为69.1％至77％。对于同心，偏心和不存在r-EBUS视图，产率分别为81.5、71.7和26.9％。诊断结果不受病变大小，密度，大叶位置或中心性的影响。结论在社区和学术中心实施RAB是安全可行的，需要诊断性支气管镜检查的肺部病变患者的初步诊断率为69.1-77％。