The Effectiveness and Safety of Robotic-Assisted Bronchoscopy Across Diverse Patient Heights: A Subset Analysis of a Multicenter, Prospective, Observational Trial.

BACKGROUND

Outcomes of robotic-assisted bronchoscopy (RAB) in patients of small stature remain uncertain due to concerns about their potentially smaller lung volumes. We assess the effectiveness and safety of RAB across height variations.

METHODS

This is a subset analysis of TARGET, a multicenter, prospective, observational study using the MONARCH Robotic Bronchoscopy Platform, which enrolled patients with lung lesions undergoing RAB across 21 sites. RAB safety and effectiveness were compared across height quartiles by assessing reach, measured through radial endobronchial ultrasound (r-EBUS) confirmation and the distance from the bronchoscope tip to the lesion, and access, evaluated by the diagnostic yield (DY). Comparisons across groups were performed via ANOVA, the Kruskal-Wallis test, or Fisher exact test as appropriate.

RESULTS

A total of 679 patients were analyzed, categorized into height quartiles: <160.02 cm (N=182), 160.03 to 167.64 cm (N=189), 167.65 to 175.26 cm (N=140), and >175.27 cm (N=168). Mean nodule size was 20.9 mm, with a distance from the pleura of 15.7 mm; 47.2% were in the outer third of the lung, with no significant differences across quartiles. r-EBUS localization succeeded in 91.7% of cases, with no quartile differences (P=0.95). The mean distance from the bronchoscope tip to the lesion was 22.6 mm, consistent across groups (P=0.84). Intermediate DY was higher in the third quartile of height, but no significant differences were observed for strict or liberal DY. Pneumothorax and bleeding rates were 4.1% and 2.4%, respectively, with no significant differences across quartiles (P=0.33 and 0.93, respectively).

CONCLUSION

Our findings demonstrate a comparable effectiveness and safety profile of RAB across varying heights.