Prospective study of comparison of hot versus cold biopsy forceps in the diagnosis of endobronchial lesions

Abstract

BACKGROUND: Electrocoagulation bronchoscopy biopsy forceps could impair the quality of the specimens obtained. credible data for either are lacking. Inhibition of platelet aggregation treatment can increase bleeding rate and most of bronchologists cease clopidogrel where biopsy is anticipated . OBJECTIVE: To evaluate the impact of hot biopsy on the quality of tissue samples and to quantify the amount of procedure-related bleeding during endobronchial biopsy. METHODS: Patients with endobronchial lesions during bronchoscopy underwent 8 endobronchial biopsies each with a hot biopsy forceps, alternating between with electrocoagulation and without. The generator was set on “soft coagulation” mode, with power settings of 20, 25, 30 and 40 W for each group of 10 patients in a sequential fashion. Overall quality of biopsy specimen and tissue damage were assessed and graded by a pulmonary pathologist. RESULT: 258 biopsy samples were performed in 40 patients. No severe side effect was related. No significant difference was detected between the qualities of specimens obtained by hot or cold biopsy in 20 , 25 and 30W (p>0.05 for all three voltages). Histological accuracy rates of 40 w hot biopsy were significantly (70%) lower than other (Hot and cold biopsy). Cautery damage, architectural distortion, and tissue fragmentation occurred more frequently using the hot biopsy technique at 40 w( P CONCLUSIONS: Hot biopsy can be a valuable alternative to forceps biopsy in evaluating endobronchial lesions. A future study is planned in pigs under Inhibition of platelet aggregation treatment.