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

Claudia Ravaglia, Martina Bonifazi, Athol U. Wells, Sara Tomassetti, Carlo Gurioli, S. Piciucchi, Alessandra Dubini, Paola Tantalocco, Stefano Sanna, Eva Vanna Lorenza Negri, Irene Tramacere, Valentina Anna Ventura, Alberto Cavazza, A. Rossi, Marco Chilosi, Carlo La Vecchia, Stefano Gasparini, Venerino Poletti

Research output: Contribution to journalArticle

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 languageEnglish
Pages (from-to)215-227
Number of pages13
JournalRespiration; international review of thoracic diseases
Volume91
Issue number3
DOIs
Publication statusPublished - Mar 1 2016

Fingerprint

Interstitial Lung Diseases
Biopsy
Safety
Lung
Pneumothorax
Meta-Analysis
Mortality

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 journalArticle

Ravaglia, C, Bonifazi, M, Wells, AU, Tomassetti, S, Gurioli, C, Piciucchi, S, Dubini, A, Tantalocco, P, Sanna, S, Negri, EVL, Tramacere, I, Ventura, VA, Cavazza, A, Rossi, A, Chilosi, M, La Vecchia, C, Gasparini, S & Poletti, V 2016, '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', Respiration; international review of thoracic diseases, vol. 91, no. 3, pp. 215-227. https://doi.org/10.1159/000444089
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. / 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. In: Respiration; international review of thoracic diseases. 2016 ; Vol. 91, No. 3. pp. 215-227.
@article{ce2843b767584003a108eeb77d34d108,
title = "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",
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.",
keywords = "Cryobiopsy, Interstitial lung disease, Video-assisted thoracoscopic surgery",
author = "Claudia Ravaglia and Martina Bonifazi and Wells, {Athol U.} and Sara Tomassetti and Carlo Gurioli and S. Piciucchi and Alessandra Dubini and Paola Tantalocco and Stefano Sanna and Negri, {Eva Vanna Lorenza} and Irene Tramacere and Ventura, {Valentina Anna} and Alberto Cavazza and A. Rossi and Marco Chilosi and {La Vecchia}, Carlo and Stefano Gasparini and Venerino Poletti",
year = "2016",
month = "3",
day = "1",
doi = "10.1159/000444089",
language = "English",
volume = "91",
pages = "215--227",
journal = "Respiration; international review of thoracic diseases",
issn = "0025-7931",
publisher = "S. Karger AG",
number = "3",

}

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 -