Safety and performance of transbronchial cryobiopsy for parenchymal lung lesions

• Verfasst von: Herth, Felix [VerfasserIn]
• Verfasst von: Mayer, Max [VerfasserIn]
• Verfasst von: Thiboutot, Jeffrey [VerfasserIn]
• Verfasst von: Kapp, Christopher M. [VerfasserIn]
• Verfasst von: Sun, Jiayuan [VerfasserIn]
• Verfasst von: Zhang, Xiaoju [VerfasserIn]
• Verfasst von: Herth, Jonas [VerfasserIn]
• Verfasst von: Kontogianni, Konstantina [VerfasserIn]
• Verfasst von: Yarmus, Lonny [VerfasserIn]
• Titel: Safety and performance of transbronchial cryobiopsy for parenchymal lung lesions
• Verf.angabe: Felix J. Herth, Max Mayer, Jeffrey Thiboutot, Christopher M. Kapp, Jiayuan Sun, Xiaoju Zhang, Jonas Herth, Konstantina Kontogianni, and Lonny Yarmus
• E-Jahr: 2021
• Jahr: 7 May 2021
• Umfang: 8 S.
• Fussnoten: Gesehen am 08.12.2021
• Titel Quelle: Enthalten in: Chest
• Ort Quelle: Amsterdam : Elsevier, 1935
• Jahr Quelle: 2021
• Band/Heft Quelle: 160(2021), 4, Seite 1512-1519
• ISSN Quelle: 1931-3543
• DOI: doi:10.1016/j.chest.2021.04.063
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: bronchoscopy
• Sach-SW: cryobiopsy
• Sach-SW: lung cancer
• Sach-SW: peripheral pulmonary lesions
• K10plus-PPN: 1780698445

Abstract

Background - Despite advances in technology, the bronchoscopic diagnosis of parenchymal pulmonary lesions (PPLs) remains difficult to achieve. Transbronchial lung cryobiopsy (TLCB) offers the potential for larger samples with improved diagnostic yield; however, a paucity of data exists describing its safety and usefulness for the diagnosis of PPL. - Research Question - What is the safety profile of TLCB for PPL? - Study Design and Methods - An observational, retrospective, multicenter cohort study enrolled patients without endobronchial disease undergoing TLCB of PPL from 2015 through 2019. All procedures were performed using both rigid and flexible bronchoscopy with a flexible cryoprobe. Complication rates, including bleeding and pneumothorax rates, were collected. Bleeding was graded on a scale from 0 (trace) to 4 (requiring surgical intervention) with a grade of ≥ 3 considered clinically significant. Pneumothorax, tube thoracostomy placement, diagnostic yield, and need for subsequent interventions were recorded. - Results - One thousand twenty-four patients underwent TLCB. One hundred eighty-eight patients (18%) experienced bleeding; in 36 patients (3.5%), the bleeding was clinically significant. Sixty-eight patients (6.6%) demonstrated a pneumothorax and 64 patients (6.3%) required drainage with tube thoracostomy. All chest drains were removed within 4 days, and no cases of prolonged air leak occurred. A definitive diagnosis was achieved in 932 patients (91%). Adenocarcinoma (46%) and metastatic disease (21%) were the most common diagnoses. - Interpretation - TLCB showed an acceptable safety profile and diagnostic yield for the evaluation of PPL in this large retrospective cohort. Prospective clinical trials are underway to validate these findings further.