Abstract
Background: A diagnosis of interstitial lung diseases (ILDs) may include surgical lung biopsy (SLB), which is associated with significant morbidity and mortality and also appreciable costs. Transbronchial lung cryobiopsy (TBLC) is adopting an important role. Objectives: The aim of this study was to compare the diagnostic yield (DY) and safety of TBLC and SLB in a large cohort of patients and to perform a systematic review of the literature as well as a meta-analysis. Methods: We performed a retrospective analysis of 447 cases with ILD undergoing TBLC and/or SLB and a systematic review of the literature (MEDLINE and Embase for all original articles on the DY and safety of TBLC in ILDs up to July 2015). Results: A total of 150 patients underwent SLB and 297 underwent TBLC. The median time of hospitalization was 6.1 days (SLB) and 2.6 days (TBLC; p <0.0001). Mortality due to adverse events was observed for 2.7% (SLB) and 0.3% (TBLC) of the patients. Pneumothorax was the most common complication after TBLC (20.2%). No severe bleeding was observed. TBLC was diagnostic for 246 patients (82.8%), SLB for 148 patients (98.7%, p = 0.013). A meta-analysis of 15 investigations including 781 patients revealed an overall DY of 0.81 (0.75-0.87); the overall pooled probability of developing a pneumothorax, as retrieved from 15 studies including 994 patients, was 0.06 (95% CI 0.02-0.11). Conclusion: Cryobiopsy is safe and has lower complication and mortality rates compared to SLB. TBLC might, therefore, be considered the first diagnostic approach for obtaining tissue in ILDs, reserving the surgical approach for cases in which TBLC is not diagnostic.
| Original language | English |
|---|---|
| Pages (from-to) | 215-227 |
| Number of pages | 13 |
| Journal | Respiration; international review of thoracic diseases |
| Volume | 91 |
| Issue number | 3 |
| DOIs | |
| Publication status | Published - Mar 1 2016 |
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Keywords
- Cryobiopsy
- Interstitial lung disease
- Video-assisted thoracoscopic surgery
ASJC Scopus subject areas
- Pulmonary and Respiratory Medicine
Cite this
Safety and Diagnostic Yield of Transbronchial Lung Cryobiopsy in Diffuse Parenchymal Lung Diseases : A Comparative Study versus Video-Assisted Thoracoscopic Lung Biopsy and a Systematic Review of the Literature. / Ravaglia, Claudia; Bonifazi, Martina; Wells, Athol U.; Tomassetti, Sara; Gurioli, Carlo; Piciucchi, S.; Dubini, Alessandra; Tantalocco, Paola; Sanna, Stefano; Negri, Eva Vanna Lorenza; Tramacere, Irene; Ventura, Valentina Anna; Cavazza, Alberto; Rossi, A.; Chilosi, Marco; La Vecchia, Carlo; Gasparini, Stefano; Poletti, Venerino.
In: Respiration; international review of thoracic diseases, Vol. 91, No. 3, 01.03.2016, p. 215-227.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Safety and Diagnostic Yield of Transbronchial Lung Cryobiopsy in Diffuse Parenchymal Lung Diseases
T2 - A Comparative Study versus Video-Assisted Thoracoscopic Lung Biopsy and a Systematic Review of the Literature
AU - Ravaglia, Claudia
AU - Bonifazi, Martina
AU - Wells, Athol U.
AU - Tomassetti, Sara
AU - Gurioli, Carlo
AU - Piciucchi, S.
AU - Dubini, Alessandra
AU - Tantalocco, Paola
AU - Sanna, Stefano
AU - Negri, Eva Vanna Lorenza
AU - Tramacere, Irene
AU - Ventura, Valentina Anna
AU - Cavazza, Alberto
AU - Rossi, A.
AU - Chilosi, Marco
AU - La Vecchia, Carlo
AU - Gasparini, Stefano
AU - Poletti, Venerino
PY - 2016/3/1
Y1 - 2016/3/1
N2 - Background: A diagnosis of interstitial lung diseases (ILDs) may include surgical lung biopsy (SLB), which is associated with significant morbidity and mortality and also appreciable costs. Transbronchial lung cryobiopsy (TBLC) is adopting an important role. Objectives: The aim of this study was to compare the diagnostic yield (DY) and safety of TBLC and SLB in a large cohort of patients and to perform a systematic review of the literature as well as a meta-analysis. Methods: We performed a retrospective analysis of 447 cases with ILD undergoing TBLC and/or SLB and a systematic review of the literature (MEDLINE and Embase for all original articles on the DY and safety of TBLC in ILDs up to July 2015). Results: A total of 150 patients underwent SLB and 297 underwent TBLC. The median time of hospitalization was 6.1 days (SLB) and 2.6 days (TBLC; p <0.0001). Mortality due to adverse events was observed for 2.7% (SLB) and 0.3% (TBLC) of the patients. Pneumothorax was the most common complication after TBLC (20.2%). No severe bleeding was observed. TBLC was diagnostic for 246 patients (82.8%), SLB for 148 patients (98.7%, p = 0.013). A meta-analysis of 15 investigations including 781 patients revealed an overall DY of 0.81 (0.75-0.87); the overall pooled probability of developing a pneumothorax, as retrieved from 15 studies including 994 patients, was 0.06 (95% CI 0.02-0.11). Conclusion: Cryobiopsy is safe and has lower complication and mortality rates compared to SLB. TBLC might, therefore, be considered the first diagnostic approach for obtaining tissue in ILDs, reserving the surgical approach for cases in which TBLC is not diagnostic.
AB - Background: A diagnosis of interstitial lung diseases (ILDs) may include surgical lung biopsy (SLB), which is associated with significant morbidity and mortality and also appreciable costs. Transbronchial lung cryobiopsy (TBLC) is adopting an important role. Objectives: The aim of this study was to compare the diagnostic yield (DY) and safety of TBLC and SLB in a large cohort of patients and to perform a systematic review of the literature as well as a meta-analysis. Methods: We performed a retrospective analysis of 447 cases with ILD undergoing TBLC and/or SLB and a systematic review of the literature (MEDLINE and Embase for all original articles on the DY and safety of TBLC in ILDs up to July 2015). Results: A total of 150 patients underwent SLB and 297 underwent TBLC. The median time of hospitalization was 6.1 days (SLB) and 2.6 days (TBLC; p <0.0001). Mortality due to adverse events was observed for 2.7% (SLB) and 0.3% (TBLC) of the patients. Pneumothorax was the most common complication after TBLC (20.2%). No severe bleeding was observed. TBLC was diagnostic for 246 patients (82.8%), SLB for 148 patients (98.7%, p = 0.013). A meta-analysis of 15 investigations including 781 patients revealed an overall DY of 0.81 (0.75-0.87); the overall pooled probability of developing a pneumothorax, as retrieved from 15 studies including 994 patients, was 0.06 (95% CI 0.02-0.11). Conclusion: Cryobiopsy is safe and has lower complication and mortality rates compared to SLB. TBLC might, therefore, be considered the first diagnostic approach for obtaining tissue in ILDs, reserving the surgical approach for cases in which TBLC is not diagnostic.
KW - Cryobiopsy
KW - Interstitial lung disease
KW - Video-assisted thoracoscopic surgery
UR - http://www.scopus.com/inward/record.url?scp=84962505685&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84962505685&partnerID=8YFLogxK
U2 - 10.1159/000444089
DO - 10.1159/000444089
M3 - Article
VL - 91
SP - 215
EP - 227
JO - Respiration; international review of thoracic diseases
JF - Respiration; international review of thoracic diseases
SN - 0025-7931
IS - 3
ER -