Efficacy and safety of transbronchial cryobiopsy in interstitial lung diseases

Abstract

Background: Transbronchial cryobiopsy (TCB) through flexible bronchoscopy (FB) represents a promising technique to obtain larger samples of higher quality and diagnostic yield in patients with interstitial lung diseases (ILDs) in comparison to forceps biopsy. Aim: The study objectives were evaluation of diagnostic yield and safety of TCB in comparison to forceps biopsy in ILDs patients. Material and Methods: Patients with ILDs indicated for lung biopsy were enrolled. Both TCB and forceps biopsies were taken from each patient with randomized sequence. Biopsies number with each technique was decided by the operator. The largest diameter of the samples was measured in mm by electronic caliper, diagnostic yield and postbronchoscopy bleeding and pneumothorax were evaluated. Results: Eighteen patients were included. The median number of TCB was 1 while forceps biopsy was 2 with significant difference (p ≤ 0.001). The measured gross diameter (mm) of obtained samples by TCB was significantly larger than that of forceps TBLB (6 vs 2.1 respectively) figure (1). The diagnostic yield of TCB was significantly higher 14 (77.8%) compared to 8 (44.4%) for forceps biopsy (p= 0.031). No bleeding was recorded after forceps in 12 (66.7%), while in TCB 9 (50%) (p= 0.250). There was no significant difference in both techniques in mild bleeding (TBC 7 vs forceps 5) (p=0.5) and moderate bleeding (TBC 2 vs forceps 1) (P= 0.5). No severe bleeding was recorded. Pneumothorax was reported in 3 (16.7%) patients after TBLB. Conclusions: TBC is effective method to obtain larger samples with higher diagnostic yield in comparison to forceps biopsy. Bleeding occurs more frequently after TCB, however without serious adverse events.