Journal Club Podcasts

Clamping trials are safe but do not appear to be associated with reduced rates of recurrent pneumothorax. An ultracautious approach using digital air leak devices in combination with clamping could represent a viable strategy in selected patients.

Veale, N., et al. (2026). "A National Evaluation of Intercostal Chest Drain Removal Strategies." Chest 169(3): 849-858.

Minor complications included haemoptysis (n = 2) and postoperative fever (n = 3), which resolved spontaneously. ENB combined with real-time 2D DSA guidance and 3D CBCT may be a feasible and safe technique for MWA of malignant pulmonary nodules.

Xu, Y., et al. (2025). "A novel technique for microwave ablation of malignant pulmonary nodules: electromagnetic navigation bronchoscopy with real-time digital subtraction angiography and computed tomography imaging guidance." Eur J Cardiothorac Surg 67(3).

Three fine needle passes were sufficient for diagnostic results, with a plateau in subsequent biopsies. Histopathologic tissue diagnosis was superior with the cryoprobe than with tissue obtained using conventional forceps.

Chen-Yost, H. I., et al. (2026). "Accuracy of Rapid On-Site Evaluation in Robotic-Assisted Bronchoscopy Fine Needle Aspirations of Lung Nodules." J Bronchology Interv Pulmonol 33(2).

BREATHE trial report providing early clinical evidence on airway scaffolds for emphysema-related hyperinflation, including feasibility, safety, physiology, and quality-of-life signals.

Tana, A., et al. (2025). "Airway Scaffolds for Emphysema-related Hyperinflation: Six-Month Results from the BREATHE Trial." Am J Respir Crit Care Med 211(7): 1175-1184.

Evidence-based AABIP guidance frames bronchoscopic diagnosis and staging of lung cancer, emphasizing local expertise, patient factors, and evolving technology when choosing sampling and staging strategies.

Miller, R. J., et al. (2025). "American Association for Bronchology and Interventional Pulmonology (AABIP) Evidence-Based Guidelines on Bronchoscopic Diagnosis and Staging of Lung Cancer." J Bronchology Interv Pulmonol 32(4).

Clinical experience with biodegradable airway stents for benign central airway stenosis, highlighting feasibility, early complications, and the need for follow-up strategies.

Karcoglu, O., et al. (2025). "Biodegradable Stents-A New Option for Benign Central Airway Stenosis." Respirology 30(12): 1176-1183.

This review surveys bronchoscopic intratumoral treatment strategies for NSCLC, highlighting how local delivery and immunotherapy combinations could expand interventional pulmonology beyond diagnosis.

DeMaio, A. and D. Sterman (2020). "Bronchoscopic intratumoural therapies for non-small cell lung cancer." Eur Respir Rev 29(156).

Consensus statement offering practical guidance on patient selection and periprocedural management for bronchoscopic lung volume reduction with endobronchial valves.

Wahidi, M. M., et al. (2026). "Bronchoscopic Lung Volume Reduction with Endobronchial Valves: A Consensus Statement on Practical Aspects of Patient Selection and Periprocedural Management." Respiration 105(3): 397-420.

PEF ablation delivered via ssRAB and EBUS for pulmonary carcinoid tumors appeared feasible and safe, with promising short-term radiographic responses. This approach may provide a minimally invasive treatment option for patients who are not candidates for surgery or radiation.

Fernandez-Bussy, S., et al. (2026). "Bronchoscopic pulsed-electric field ablation for carcinoid tumor: robotic-assisted and non-robotic approach." Lung Cancer 214: 109333.

Preclinical porcine study supporting the feasibility and safety of bronchoscopy-guided synergistic irreversible electroporation for lung lesion ablation near critical structures.

Zhang, J., et al. (2026). "Bronchoscopy-guided synergistic pulsed irreversible electroporation ablation as a novel intervention therapy for lung lesions: A pilot study in a preclinical model." Transl Res 291: 40-50.

Protocol for the RELIEF randomized trial comparing regular saline flushing with as-needed flushing for small-bore chest drains in pleural infection.

Boyle, T. K., et al. (2026). "Chest drain REgular FLushing in ComplIcated parapneumonic EFfusions and empyemas: Study protocol for the RELIEF randomized controlled trial." PLoS One 21(3): e0331725.

A large surgical pGGN cohort links CT size and density features with invasive pathology and molecular or immune markers, supporting a nomogram to guide surveillance and treatment decisions.

Zhu, S., et al. (2026). "Clinic-radiologic predictors of pathological characteristics in pure ground-glass nodules: Development and validation of a predictive nomogram." J Thorac Cardiovasc Surg 171(3): 742-753.e717.

We recommend choosing the valve type based on individual bronchial anatomy. However, further randomized studies are needed to confirm our results.

Sgarbossa, T., et al. (2025). "Comparison of Efficacy and Safety of Different Types of One-Way Valves in Endoscopic Lung Volume Reduction in Patients with Severe Lung Emphysema." Respiration 104(4): 281-289.

Multicenter randomized trial comparing high-flow nasal cannula with conventional oxygen therapy during bronchoscopy in high-risk patients.

Qin, H., et al. (2025). "Comparison of High-Flow Nasal Cannula and Conventional Oxygen Therapy for High Risk Patients During Bronchoscopy Examination: A Multicenter Randomized Controlled Trial." Ann Am Thorac Soc 22(7): 1018-1026.

Randomized trial comparing bronchoscopic cryobiopsy with forceps biopsy for peripheral lung lesions, highlighting tissue acquisition strategy and safety considerations.

Thiboutot, J., et al. (2026). "Cryobiopsy vs Forceps for Bronchoscopic Lung Biopsy: The FROSTBITE-2 Randomized Clinical Trial." Jama 335(23): 2038-2045.

Long-term multidisciplinary program experience suggesting robotic bronchoscopy can serve as an initial sampling approach for solid lung lesions with acceptable performance and low complication rates.

Deitz, R. L., et al. (2026). "Diagnostic Outcomes of Robotic Bronchoscopy in a Multidisciplinary, Multi-Hospital Lung Nodule Program." J Surg Res 324: 210-220.

The findings will be disseminated through journal publications and conference presentations. NCT06741839.

Deng, M. M., et al. (2026). "Diagnostic yield and safety of probe-based confocal laser endomicroscopy-guided pleural biopsy via semirigid thoracoscope in diagnosing patients with unknown pleural effusion: a protocol for a multicentre, randomised controlled trial (COLLABORATION-I)." BMJ Open 16(6): e117208.

Randomized ENB study evaluating how needle aspiration and forceps biopsy contribute to diagnostic yield for peripheral pulmonary lesions.

Kim, Y. W., et al. (2025). "Diagnostic Yield and Synergistic Impact of Needle Aspiration and Forceps Biopsy With Electromagnetic Navigation Bronchoscopy for Peripheral Pulmonary Lesions: A Randomized Controlled Trial." Chest 168(1): 236-247.

Study of airway stenting for airway-esophageal fistula, focused on symptom palliation, quality of life, and survival in esophageal cancer-associated fistula.

Li, X., et al. (2025). "Efficacy and Safety of Airway Stent Placement in the Treatment of Airway Esophageal Fistula." Respiration 104(7): 476-484.

This study supports this novel system as an alternative to cryoablation via bronchoscope for MCAO patients. ChiCTR2100042051.

Liu, J., et al. (2025). "Efficacy and safety of novel airway balloon cryoablation system for malignant central airway obstruction: a prospective, multicentre, randomised, non-inferiority study." Thorax 80(11): 820-828.

This EBUS-TBNA study evaluates whether changing needles between N2 stations matters when ROSE is unavailable, favoring selective use in higher-risk settings over routine needle changes.

Sagar, A. S., et al. (2026). "Estimating False Multistation N2 Upstaging From Cross-Contamination During EBUS-TBNA Without ROSE: Insights From a Monte Carlo Analysis." J Bronchology Interv Pulmonol 33(3).

Opinions on implementing TNM-9 are inconsistent, within the IP community, particularly regarding needle change for different N2 stations. Education, reliable data, and consensus guidelines are needed.

Kontogianni, K., et al. (2026). "Global Survey on Current Practices of Endobronchial Ultrasound Approaches to N2 Staging in Non-Small Cell Lung Cancer Following the Ninth Edition of the TNM Classification." J Bronchology Interv Pulmonol 33(1).

HFNC significantly reduces hypoxemic events and improves oxygenation compared with COT during bronchoscopy. Although anesthetic use slightly increased, there was no difference in procedure time or patient comfort.

Miranda Fliess de Castro, R., et al. (2026). "High-Flow Nasal Cannula Versus Conventional Oxygen Therapy During Bronchoscopy: A Meta-Analysis of Randomized Controlled Trials." J Bronchology Interv Pulmonol 33(3).

Cryoablation may inhibit stenosis progression by reducing TGF-1-regulated extracellular matrix deposition and fibrosis. These findings provide mechanistic insights into cryotherapy's therapeutic benefits for BCAS management.

Chae, G., et al. (2026). "Impact of cryotherapy on airway stenosis: In vivo, ex vivo, and in vitro studies." J Therm Biol 136: 104399.

Procedures performed with fellows on the steepest portion of the ADB learning curve are the least efficient. Fellowship directors and faculty bronchoscopists should acknowledge these potential impacts on ABD practice while optimizing the approach to bronchoscopy training.

Chrissian, A. A., et al. (2025). "Impact of Pulmonary and Critical Care Fellow Participation during Advanced Diagnostic Bronchoscopy." ATS Sch 6(1): 36-51.

Our results indicate that discordant pleural effusions are common and represent a biologically distinct entity with different diagnostic patterns compared with concordant effusions. Clinicians should assess for discordance early and tailor investigations accordingly.

Addala, D. N., et al. (2025). "Incidence of Discordant Pleural Fluid Exudates and Diagnostic Patterns: A Retrospective Cohort Study." Chest 168(6): 1517-1527.

Framework article describing collaboration between interventional pulmonology and thoracic surgery for advanced pulmonary care, program design, and embedded clinical research.

Swenson, K., et al. (2026). "Integrating interventional pulmonology and thoracic surgery: a multidisciplinary approach to advanced pulmonary care." J Thorac Dis 18(2): 159.

Retrospective BLVR study identifying risk factors and clinical impact of severe pneumothorax after endobronchial valve therapy.

Brock, J. M., et al. (2025). "Lessons Learned: Risk Factors and Clinical Impact of Severe Pneumothorax After Endoscopic Lung Volume Reduction With Endobronchial Valves." Chest 167(4): 1012-1023.

These results support the need for identifying best practice and standardisation of LAT practices, with outcome reporting. These survey results will form the basis of applications to the national and international respiratory societies to develop relevant standards.

Westley, R., et al. (2025). "Local Anaesthetic Thoracoscopy Practice in the UK in 2024: A Snapshot Survey." Respiration 104(10): 730-735.

Therapeutic options and outcomes are dependent on the underlying etiology of CAO. A multidisciplinary approach and shared decision-making with the patient are strongly encouraged.

Mahmood, K., et al. (2025). "Management of Central Airway Obstruction: An American College of Chest Physicians Clinical Practice Guideline." Chest 167(1): 283-295.

Phase 3 trial of talc poudrage with or without indwelling pleural catheter insertion during medical thoracoscopy for symptomatic malignant pleural effusion.

Dipper, A., et al. (2026). "Medical thoracoscopy with talc poudrage and indwelling pleural catheter insertion versus medical thoracoscopy with talc poudrage alone for patients with symptomatic malignant pleural effusion (TACTIC): a randomised, controlled phase 3 trial." Lancet Respir Med 14(4): 341-349.

Randomized noninferiority trial suggesting artificial pneumothorax may not be necessary before medical thoracoscopy in patients with minimal or absent pleural effusion.

Wang, K., et al. (2026). "Medical Thoracoscopy With vs Without Prior Artificial Pneumothorax for Patients With Minimal or Absent Pleural Effusion." Chest 169(1): 269-279.

Randomized comparison of navigational bronchoscopy and transthoracic needle biopsy for lung nodules, useful for discussing diagnostic strategy, yield, and complication tradeoffs.

Lentz, R. J., et al. (2025). "Navigational Bronchoscopy or Transthoracic Needle Biopsy for Lung Nodules." N Engl J Med 392(21): 2100-2112.

Study of pleural manometry in pneumothorax evaluating tension physiology and whether pressure measurements help predict clinical outcomes.

Latifi, A., et al. (2026). "Pleural Manometry in Pneumothorax: Evaluating Tension Physiology and Predicting Outcomes." Chest 169(3): 830-836.

Multicenter study suggesting post-thoracentesis ultrasound can be an effective alternative to chest radiography for evaluating pleural space evacuation in simple effusions.

Ratwani, A., et al. (2025). "Post-Thoracentesis Ultrasound versus Chest Radiography for the Evaluation of Effusion Evacuation and Lung Reexpansion: A Multicenter Study." Ann Am Thorac Soc 22(9): 1321-1328.

Pilot study of proceduralist-directed rapid on-site pathologic evaluation using dynamic cell imaging, with high concordance between intraprocedural assessment and final pathology.

Matus, I., et al. (2026). "Proceduralist-Directed Rapid On-Site Pathologic Evaluation (ROPE) Using Dynamic Cell Imaging: A Pilot Study of Peripheral Pulmonary Lesion Sampling Through Robotic Bronchoscopy." J Bronchology Interv Pulmonol 33(1).

Implementation of a formal IPN program can reduce time-to-diagnosis of lung cancer in patients presenting with an IPN by 134 days compared with traditional referral patterns. Formal IPN programs can result in a shift towards an earlier stage of diagnosis for lung cancer.

Mahajan, A. K., et al. (2026). "Reduction in Time-to-Diagnosis for Lung Cancer Resulting From Implementation of a Formal Incidental Pulmonary Nodule (IPN) Program Compared With Traditional Referral Pathways." J Bronchology Interv Pulmonol 33(2).

Single-center experience suggesting ssRAB plus mobile CBCT-guided cryobiopsy can achieve high diagnostic yield for GGO-predominant peripheral nodules with a favorable safety profile.

Zhang, C., et al. (2026). "Robotic-assisted bronchoscopy-guided cryobiopsy for the diagnosis of ground-glass opacity-predominant peripheral pulmonary nodules." Respir Res.

Two subjects died during the follow-up period. Transbronchial RFA utilizing an automatic saline microperfusion system is a viable, safe and efficacious approach for the treatment for lung tumours, particularly for patients with GGNs.

Zhong, C., et al. (2025). "Safety and efficacy of a novel transbronchial radiofrequency ablation system for lung tumours: One year follow-up from the first multi-centre large-scale clinical trial (BRONC-RFII)." Respirology 30(1): 51-61.

Early clinical report of bronchoscopic pulsed electric field ablation for lung cancer and metastases, emphasizing procedural safety and mixed early local-control signals.

Mahmood, K., et al. (2026). "Safety and Efficacy of Bronchoscopic Pulsed Electric Field Ablation for Lung Cancer and Metastases." JTO Clinical and Research Reports: 100983.

Single-center experience suggesting rigid bronchoscopy for complex airway disease can be performed safely in a bronchoscopy suite for carefully selected patients.

Mahajan, A. K., et al. (2025). "Safety and feasibility of performing rigid bronchoscopy in the bronchoscopy suite instead of the operating room." J Thorac Dis 17(6): 3667-3672.

In pleural infection, saline lavage alone results in a longer drainage duration than IET. In this small superiority trial, adding saline lavage to IET did not demonstrate a clinically meaningful advantage over IET alone.

Porcel, J. M., et al. (2026). "Saline lavage alone prolongs drainage compared with intrapleural enzyme therapy in pleural infection: the SCOPE randomised controlled trial." Eur Respir J 67(6).

Feasibility series of ssRAB-guided transbronchial cryoablation for primary and metastatic pulmonary nodules, with favorable short-term safety and early local-control findings.

Xu, L., et al. (2026). "Shape-Sensing Robotic-Assisted Bronchoscopic Cryoablation for Primary and Metastatic Pulmonary Nodules: Feasibility, Safety, and Early Outcomes." Respiration: 1-13.

Prospective multicenter CONFIRM study of shape-sensing robotic bronchoscopy with integrated mobile CBCT for small nodules, focused on tool-in-lesion verification and outcomes.

Husta, B. C., et al. (2026). "Shape-sensing robotic-assisted bronchoscopy with integrated mobile cone-beam CT for small nodules: results from the prospective multicentre CONFIRM study." Thorax 81(3): 267-275.

Randomized trial suggesting shear-wave elastography guidance can improve diagnostic yield and shorten biopsy time for subpleural lung lesions without increasing complications.

Kuo, Y. W., et al. (2026). "Shear-wave elastography-guided transthoracic biopsy for lung lesions: a randomised controlled trial." Eur Respir J 67(3).

Multi-institutional experience showing bronchoscopic ICG-soaked fiducial markers can help surgeons localize small peripheral lesions and support lung-sparing resection.

Benn, B. S., et al. (2025). "Spot On: Indocyanine Green-Soaked Fiducial Markers for Lung Nodules Prior to Thoracic Surgery." CHEST Pulmonary 3(1): 100131.

Randomized trial showing lateral decubitus positioning reduced atelectasis obscuring dependent robotic bronchoscopy targets and improved tool-in-lesion confirmation.

Boster, J. M., et al. (2026). "Superiority of Lateral Decubitus Strategy in Preventing Atelectasis From Obscuring Targets During Robotic Bronchoscopy: Lateral Decubitus Strategy vs Ventilatory Strategy to Prevent Atelectasis Trial." Chest 169(4): 1124-1134.

Tracheobronchial stenting incidence and mortality for CAO have both increased over time. Regional variation and high in-hospital mortality highlight the need to better define indications and track outcomes of tracheobronchial stenting in patients with CAO.

Wayne, M. T., et al. (2026). "Temporal Trends and Mortality in Tracheobronchial Stenting in the United States: a national cohort study." Ann Am Thorac Soc.

Thoracoscopic TPC placements may be associated with higher pleurodesis rates compared with a percutaneous technique. Our results are only hypothesis-generating, and these findings warrant confirmation in prospective studies.

Lin, J., et al. (2025). "The Impact of Video-assisted Thoracoscopic Versus Percutaneous Tunneled Pleural Catheter Techniques on Pleurodesis Outcomes: A Retrospective, Single-center Study." J Bronchology Interv Pulmonol 32(2).

Preoperative pulmonary rehabilitation and smoking cessation were emphasized. This STS consensus defines perioperative quality standards for CT LCS programs, supporting shared decision-making, multidisciplinary care, and quality improvement.

Servais, E. L., et al. (2026). "The Society of Thoracic Surgeons (2025) Expert Consensus Document on Interventions for Screen-Detected Lung Nodules." Ann Thorac Surg 121(6): 1283-1297.

Thirty-three (46%) children required a repeat bronchoscopic procedure. Like adults, multimodality therapeutic bronchoscopic airway interventions are feasible and safe in children for CAO and other central airway indications.

Madan, K., et al. (2025). "Therapeutic Bronchoscopic Interventions for Non Foreign-Body Removal Indications in Children." Pediatr Pulmonol 60(1): e27462.

ssRAB with CBCT can effectively reach and biopsy small pulmonary nodules, including perifissural, peripleural and paramediastinal lesions with a strong safety profile. NCT05867953.

Chan, L. T., et al. (2026). "Tool in lesion verification of shape-sensing robotic-assisted bronchoscopy with cone beam CT in sampling peripheral pulmonary nodules." Thorax 81(6): 571-580.

A VR anatomy trainer was preferred by learners because it provided visualization that aligned best with the procedural perspective. This approach helped learners of all spatial reasoning ability improve their procedural performance.

New, M. L., et al. (2025). "Virtual Reality Anatomy Trainer Turns Teaching Endobronchial Ultrasound Inside-Out." Chest 167(5): 1440-1450.

WABIP guideline addressing airway stenting for benign central airway obstruction, using systematic evidence review, expert experience, and modified Delphi consensus.

Chaddha, U., et al. (2025). "World Association for Bronchology and Interventional Pulmonology (WABIP) Guidelines on Airway Stenting for Benign Central Airway Obstruction." Respirology 30(7): 587-604.