Transbronchial Lung Biopsy Using Cryoprobes

Abstract

Background and objectivesTransbronchial lung biopsy (TBLB) is a bronchoscopy procedure used to obtain peripheral lung tissue. Small size samples and artefacts lead to variable, and usually poor, diagnostic yield. The use of cryoprobes may enable larger size and better quality biopsy samples to be obtained. The purpose of this study was to evaluate the feasibility of TBLB with cryoprobes and analyse the histological quality of samples obtained. Patients and methodsWe selected 10 patients with interstitial lung disease who were suitable for TBLB. A cryoprobe (Erbokryo CA®, Erbe, Germany) was introduced through the bronchoscope work channel. Then, under fluoroscopic control, the cryoprobe was placed in an area of the peripheral lung previously selected according to CT findings. A temperature of −89.5° C was applied for 3s and the cryoprobe and bronchoscope were removed with the frozen lung sample attached to the probe. The procedure was performed under sedation and the patient was intubated to allow bronchoscope and cryoprobe removal. Safety, duration of the procedure and histological findings has been evaluated. ResultsThere were 10 patients (64±8 years, 6 males). Procedure length was 35min. The specimen area was 9.5mm2 (range 3 to 25mm2) and the mean number of alveolar spaces was 29.62. No pneumothorax was registered. 6/10 patients had mild post-biopsy bleeding controlled with standard bronchoscopy measures. ConclusionsThe use of cryoprobes for TBLB may become an alternative technique to increase diagnostic yield.