Elucidating diagnostic efficacy and safety of the procedure: cryobiopsy of endobronchial lesions with a flexible bronchoscope

Abstract

When compared to conventional forceps biopsy, the use of a flexible cryoprobe allows for the sampling of endobronchial lesions, yielding well-preserved, circumferential, and substantial specimens, resulting in a higher diagnostic yield, as demonstrated in multiple studies. We evaluated the utility of cryobiopsy in the diagnosis of endobronchial lesions as well as its safety profile in this study. This retrospective study included 200 patients who underwent cryobiopsy for bronchoscopically visible endobronchial lesions between March 2016 and July 2022. Cryobiopsy was performed under conscious sedation using a flexible cryoprobe. Data on baseline patient characteristics, post-biopsy bleeding, and final histopathological diagnosis were collected. We evaluated the procedure's diagnostic yield and safety. The majority of the patients were male (84.5%) and the mean age of the patients was 56.96±13.64 years. In our study, the average size of cryobiopsy specimen was 6.8±1.2 mm. In 93% of cases, a definitive diagnosis was established; the most common diagnosis was squamous cell carcinoma of the lung (42.5%), followed by adenocarcinoma (18.5%) and small cell carcinoma (13.5%). Tuberculosis and sarcoidosis were reported in 2.5% and 1% of cases, respectively. In this study, 1% of patients had severe bleeding that required intubation and ICU admission, while 26% had moderate bleeding that was treated with cold saline and local epinephrine instillation. No mortality was reported in the study. Endobronchial cryobiopsy with a flexible bronchoscope is a safe procedure with a high diagnostic yield. This approach, which has a favorable safety profile, holds the promise of improving diagnostic and treatment outcomes in lung cancer and other benign lung diseases.