Lung Cryobiopsy Outside of the Operating Room: A Safe Alternative to Surgical Biopsy

Vanessa Menezes, Juan Carlos Molina, Clare Pollock, Philippe Romeo, Julie Morisset, Pasquale Ferraro, Edwin Lafontaine, Jocelyne Martin, Basil Nasir, Charles Leduc, Moishe Liberman

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: Transbronchial lung cryobiopsy (TBLC) is a promising technique that can provide a histologic diagnosis in interstitial lung diseases (ILD) and is an alternative to surgical lung biopsy. The main concerns with the procedure are safety and diagnostic accuracy. The technique is applicable in patients unable to undergo surgical biopsy due to severe comorbidities or when patient transport to the operating room is dangerous. This study reports the initial experience with TBLC on a thoracic surgical service as a first attempt at diagnosis in patients with diffuse parenchymal lung diseases (DPLD). Methods: Between May 2018 and July 2020, 32 patients underwent TBLC using bedside flexible bronchoscopy for suspected ILD on a thoracic surgical endoscopy service. Retrospective evaluation of the procedure details, complications, and diagnostic yield were analyzed and reported. Results: A total of 89 pathological samples were obtained (mean 2.8 per patient). Pneumothorax and minor bleeding occurred in 25% and 16.7% of patients, respectively. Sixty-seven percent of complications occurred with use of the 2.4 mm cryoprobe (P = 0.036). Concordance between the histologic diagnosis and final clinical diagnosis was observed in 62.5% of patients and the pathology guided the final treatment in 71% (P = 0.027) with Kappa-concordance of 0.60 (P < 0.001). Conclusions: Cryobiopsy is becoming part of the diagnostic evaluation in patients with indeterminate DPLD or hypoxemic respiratory failure. TBLC is easy to perform and has a favorable safety profile. Thoracic specialists should consider adding TBLC to their procedural armamentarium as a first option for patients with indeterminate PLD.

Original languageEnglish
Pages (from-to)463-469
Number of pages7
JournalInnovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
Volume16
Issue number5
DOIs
Publication statusPublished - Sep 2021
Externally publishedYes

Keywords

  • cryobiopsy
  • interstitial lung disease
  • surgical lung biopsy

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

Fingerprint

Dive into the research topics of 'Lung Cryobiopsy Outside of the Operating Room: A Safe Alternative to Surgical Biopsy'. Together they form a unique fingerprint.

Cite this