Comparative study of percutaneous and transbronchial lung parenchyma cryoablation using a porcine model

Abstract

BACKGROUND: Cryoablation is less invasive for certain selected and inoperable pulmonary lesions, which can be treated via percutaneous or transbronchial approaches. OBJECTIVE: To examine the effect of percutaneous cryoablation using an porcine lung parenchyma model. MATERIALS AND METHODS: Nitrogen-cooled cryoprobe was inserted into the posterior lobe of the peripheral lung parenchyma of six healthy female pigs percutaneously under CT guidance. Double and triple freezethaw cycles were performed on the left lung and the right lung, respectively. CT images were obtained before, during and after cryoablation. Blood samples were collected at various time points for testing. Tissue samples from the ablation zone were obtained after cryoablation for histopathological analysis. Data from the percutaneous study were compared with previously published transbronchial cryoablation data. RESULTS: The cryoablation outcomes and inflammatory responses observed in the percutaneous group were largely consistent as compared to those previously published in the transbronchial groups. Similar trends in the histopathological transition from the center to the periphery of the ablation zone and tissue repair process was exhibited between two groups within 4 weeks. Two cases of pneumothorax occurred in the percutaneous group. CONCLUSION: Cryoablation of the peripheral lung parenchyma by both percutaneous and transbronchial methods is safe and effective. Transbronchial approach demonstrates a lower complication rate than the percutaneous method. Two approaches complement one another for minimally invasive treatment of lung cancers.