{
  "abstract": "Bronchus-unconnected peripheral pulmonary lesions (PPLs) pose diagnostic challenges due to lack of direct airway access and computed tomography (CT)-to-body divergence (CTBD). We evaluated robotic-assisted bronchoscopy (RAB) combined with the intraprocedural CT-guided navigation with ventilatory strategy for atelectasis (ICNVA) strategy. This prospective, single-arm study enrolled patients (18-75 years) with pulmonary nodules (6-30 mm) lacking a bronchus sign. All underwent RAB with the ICNVA strategy, integrating preoperative mapping, intraprocedural breath-holds to minimize atelectasis, and real-time CT confirmation. The primary endpoint was tool-in-lesion (TIL) rate. Secondary endpoints included diagnostic yield, center strike rate, CTBD, and safety. Thirty patients were enrolled (mean age 55.6±10.7 years). Lesions had a mean diameter of 14.0±4.3 mm and a median distance to the nearest bronchus of 18 mm. The ICNVA strategy resulted in a mean CTBD of 13.4 mm. We achieved a 100% (30/30) navigational success rate (TIL) and a 66.7% (20/30) center strike rate. The overall diagnostic yield was 90% (27/30), with 90.9% (20/22) sensitivity for malignancy. Pneumothorax occurred in 2 patients (6.7%) and mild hemorrhage in 7 (23.3%), with no severe adverse events occurred. RAB combined with the ICNVA strategy demonstrates high diagnostic yield and safety for bronchus-unconnected PPLs. This approach effectively mitigates CTBD, enabling precise localization and sampling of lesions traditionally considered difficult to access.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Thoracic Surgery, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, China.",
    "Department of Thoracic Surgery, Jiangxi Hospital of China-Japan Friendship Hospital, National Regional Center for Respiratory Medicine, Nanchang, China.",
    "Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, China.",
    "Department of Respiratory and Critical Care Medicine, Jiangxi Hospital of China-Japan Friendship Hospital, National Regional Center for Respiratory Medicine, Nanchang, China."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 3,
  "authors": [
    {
      "affs": [
        0,
        1
      ],
      "name": "Shaohua Dai"
    },
    {
      "affs": [
        2,
        3
      ],
      "name": "Wei Zuo"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Bentong Yu"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/5jc4rkv5r3byp.bib",
  "cited_by": 0,
  "doi": "10.21037/jtd-2026-2361",
  "fulltext_url": "https://europepmc.org/articles/PMC13740804",
  "id": "5jc4rkv5r3byp",
  "issns": [
    "2072-1439",
    "2077-6624"
  ],
  "landing_url": "https://europepmc.org/article/MED/42996979",
  "language": "eng",
  "licence": "CC-BY-NC-ND",
  "licence_label": "CC BY-NC-ND",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2740|Lung Cancer Diagnosis and Treatment"
    ]
  ],
  "openalex": "W7224086108",
  "pdf_url": "https://europepmc.org/articles/PMC13740804?pdf=render",
  "pmcid": "PMC13740804",
  "pmid": "42996979",
  "published": "2026-09-30",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/5jc4rkv5r3byp.ris",
  "sources": [
    {
      "first_seen": "2026-11-09T15:20:41Z",
      "native_id": "MED:42996979",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42996979"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2740|Lung Cancer Diagnosis and Treatment",
      "subfield": "general"
    }
  ],
  "title": "Evaluating robotic-assisted bronchoscopy for bronchus-unconnected peripheral pulmonary nodules: diagnostic efficacy and safety.",
  "title_text": "Evaluating robotic-assisted bronchoscopy for bronchus-unconnected peripheral pulmonary nodules: diagnostic efficacy and safety.",
  "type": "peer-reviewed",
  "updated_at": "2026-11-09T15:20:41Z",
  "url": "https://research.draconitic.com/paper/5jc4rkv5r3byp",
  "venue": "Journal of thoracic disease",
  "versions": []
}