Abstract
SESSION TITLE: Emerging Techniques for Interventional Pulmonary SESSION TYPE: Original Investigations PRESENTED ON: 10/20/2019 2:15 PM - 3:15 PM PURPOSE: Prophylactic balloon blockers are placed to prevent blood flooding into the large central airway during cryobiopsy. However, the blocker may interfere with, and increase the difficulty of, the cryobiopsy procedure. This study evaluated a novel and simple technique using a long silicone endobronchial tube as a drain for bleeding during cryobiopsy. METHODS: Under local anesthesia and moderate conscious sedation, a customized silicone tube (5.0 mm inner diameter, 40 or 48 cm in length) was advanced through the nose and trachea to the target bronchus under bronchoscopic control using a 4.0- or 4.2-mm thin bronchoscope and firmly wedged into the target bronchus to prevent blood leakage from the tube during the cryobiopsy. A forceps biopsy was performed followed by a cryobiopsy using a 1.9-mm cryoprobe through the wedged tube. Patients who underwent cryobiopsies using the tube-wedging method for diagnosing peripheral lung lesions from April 2018 to January 2019 were reviewed retrospectively. RESULTS: Twenty-four patients (diffuse lesions in 13 and localized lesions in 11) underwent cryobiopsies using the tube-wedging method during the study period. A median of three specimens (range; one to six specimens) were obtained by cryobiopsy. Cryobiopsy and forceps biopsy provided diagnostic material in 17 patients (71%) and 12 patients (50%), respectively. Median bronchoscopy time was 33.5 min (range; 16−56 min). Bleeding was controlled easily in all patients by bronchoscopic blood suctioning within the wedged tube, and there was no blood flooding out of the tube. CONCLUSIONS: The tube-wedging method is simple and safe, and may be a promising alternative to the balloon occlusion method for cryobiopsy. CLINICAL IMPLICATIONS: The tube-wedging method is a valuable option for safely performing a cryobiopsy. DISCLOSURES: No relevant relationships by Masahide Oki, source=Web Response No relevant relationships by HIDEO SAKA, source=Web Response
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