Comparison of Diagnostic Yield and Safety between Semirigid Pleuroscopic Cryobiopsy and Forceps Biopsy for Undiagnosed Pleural Effusion

Lee, Chung Shu; Li, Shih Hong; Chang, Chih Hao; Chung, Fu‐Tsai; Chiu, Li Chung; Chou, Chun Liang; Wang, Chih Wei; Lin, Shu Min

doi:10.1155/2019/5490896

Cited by 6 publications

(7 citation statements)

References 21 publications

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“…The definition of bleeding severity varied across studies. In most of the studies, slight or self-limited bleeding was reported which was similar between cryobiopsy and forceps biopsy groups ( 12 , 13 , 18 , 21 , 23 ). Our pooled analysis revealed that there were no significant differences in the mild to moderate bleeding events between the cryobiopsy and forceps biopsy groups.…”

Section: Discussionmentioning

confidence: 76%

“…All studies were published after 2015. Among those 15 studies, eight prospective studies ( 12 , 15 , 17 , 20 , 21 , 28 – 30 ), four retrospective studies ( 13 , 18 , 19 , 31 ), two cases series ( 14 , 16 ) and one randomized controlled trial ( 23 ) were analyzed, comprising 1061 biopsies (555 cryobiopsies and 506 forceps biopsies). Cryobiopsy of pleura was obtained in most patients (in 11 out of 15 studies) using cryoprobe 2.4 mm diameter.…”

Section: Resultsmentioning

confidence: 99%

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Efficacy and Safety of Pleural Cryobiopsy vs. Forceps Biopsy for Evaluation of Undiagnosed Pleural Effusion: A Systematic Review and Meta-Analysis

et al. 2022

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BackgroundPleural cryobiopsy is a novel technique for the diagnosis of pleural pathologies. However, the safety and feasibility of this modality compared to standard forceps for pleural biopsy has not been fully elucidated. This systematic review and meta-analysis aims to establish the efficacy and safety of cryobiopsy for evaluation of undiagnosed pleural effusion.MethodsFor this systematic review and meta-analysis, we searched PubMed, Embase, Scopus, and Web of science databases up to December 16, 2021 to identify relevant articles. We included randomized controlled trials, cohort studies, retrospectives studies and case series that compared pleural cryobiopsy and forceps biopsy. A qualitative assessment was performed using the QUADAS-2 tool.ResultsOf the 365 articles identified by our search, 15 studies were eligible for inclusion. The specimen sizes obtained with cryobiopsy were significantly larger compared with forceps biopsy (Standard mean difference 1.16; 95 % CI: 0.51–1.82; P < 0.01). Furthermore, the cryobiopsy tissue specimens were deeper (OR 2.68; 95 % CI: 1.39–5.16; P < 0.01) and qualitatively better with less crush artifacts (OR 0.06; 95 % CI: 0.01–0.26; P < 0.01). There was no significant difference in diagnostic yield (OR 1.32; 95 % CI: 0.79–2.21; P = 0.29) and mild to moderate bleeding events (OR 1.21; 95 % CI: 0.64–2.29; P = 0.57) between pleural cryobiopsy and forceps biopsy. No publication bias was observed among these studies.ConclusionsCompared to flexible forceps biopsy pleural cryobiopsy obtained larger and deeper tissue specimens with less crush artifacts but does not show superiority for diagnostic yield. Further studies are still needed to verify these findings.

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Section: Discussionmentioning

confidence: 76%

Section: Resultsmentioning

confidence: 99%

Efficacy and Safety of Pleural Cryobiopsy vs. Forceps Biopsy for Evaluation of Undiagnosed Pleural Effusion: A Systematic Review and Meta-Analysis

et al. 2022

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“…The hemorrhagic pleural effusion will be considered when the RBCS detected > 10 HPF. Empyema was diagnosed if there is organism or inflammatory cells and if there is atypical mesothelial cell malignancy was suspected and to be confirmed by tissue biopsy either by VATS or open biopsy as shown as table (2). Data are represented as mean ± SD or Number (%).…”

Section: Resultsmentioning

confidence: 99%

“…We have different modalities for diagnosis and hence establishing the management control for the pleural effusion. The diagnosis of the pleural effusion starting from chest x-ray, CT chest, MRI, ultrasound-guided aspiration, video-assisted thoracoscopic surgery (VATS) and open thoracotomy (2) .…”

Section: Introductionmentioning

confidence: 99%

Comparative Study of Aspiration Cytology, Video-Assisted Thoracoscope and Open Biopsy in Undiagnosed Pleural Effusion

Kotb¹,

AbdRabouh²,

Abouiznied³

et al. 2022

The Egyptian Journal of Hospital Medicine

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Background: Pleural effusion is a common challenging problem in the cardiothoracic surgery. We have different modalities for diagnosis and hence establishing the management control for the pleural effusion. Objectives: The aim of the study was to compare outcomes, in patients who underwent video-assisted thoracoscope (VATS) and patients who underwent aspiration cytology and standard thoracotomy, in diagnosis of pleural effusion. Patients and methods: This randomized clinical (interventional) study was conducted in Cardiothoracic Surgery Department, Zagazig University Hospitals. We included 48 patients with undiagnosed pleural effusion after initial and repeated biochemical and cytological analysis of the pleural fluid, they were enrolled in this study. Patients were randomly divided into three groups. Group A: Where all patients were subjected to aspiration cytology, group B: 35 cases were subjected to VATS biopsy in undiagnosed pleural effusion and group C: 13 cases were subjected to open biopsy in undiagnosed pleural effusion. Results: Pleural effusion was diagnosed by CT preoperatively and also confirmed by intra-operative findings either by VATS or by open biopsy and there were no differences between CT and intra-operative findings in presence of pleural effusion, pleural nodules and lung masses. While, there was significant difference regarding pleural thickening and mediastinal LN. 5 patients (14.3%) in VATs biopsy group failed and converted to open biopsy, 3 of them because of adhesion and 2 cases because of hemorrhage. Conclusion: Video-assisted thoracoscope is safe and minimally invasive procedure in undiagnosed pleural effusion with less operative time, blood loss, chest tube duration, intra-operative and post-operative complications and length of hospital stay compared to open biopsy.

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“…In clinical practice, undiagnosed pleural effusion is frequently encountered even after thoracentesis and closed tube biopsy. Recent evidence suggests that semi-rigid pleuroscope is an effective diagnostic tool for undiagnosed pleural effusion [11]. Semi-rigid pleuroscopy is conducted by a non-surgical pulmonologist in the endoscopy suite, with patients under local anesthesia and conscious sedation.…”

Section: Introductionmentioning

confidence: 99%

Diagnosis of Tuberculosis Pleurisy with Three Endoscopic Features via Pleuroscopy

Lee

Chang

et al. 2020

Preprint

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Background: Tuberculosis (TB) is a constant threat even with worldwide active public health campaign. Diagnosis of TB pleurisy is challenging in case of pleural effusion of unknown origin after aspiration analysis. The study was designated to demonstrate a simple image interpretation technique to differentiate TB pleurisy from non-TB pleurisy using semi-rigid pleuroscopy. Methods: The study retrospectively enrolled 117 patients who underwent semi-rigid pleuroscopy from April 2016 to August 2018 in a tertiary hospital. We analyzed the possibility of TB pleurisy using three simple pleuroscopic images via semi-rigid pleuroscopy. Results: Among 117 patients, 28 patients (23.9%) were diagnosed with TB pleurisy. Sago-like nodules/micronodules, adhesion, and discrete distribution were noted in 20 (71.4%), 20 (71.4%), and 19 (67.9%) patients with TB pleurisy, respectively. Sago-like nodules/micronodules, adhesion, and discrete distribution were noted in 6 (6.7%), 37 (41.6%), and 0 (0.0%) patients with non-TB pleurisy, respectively. The positive and the negative predictive values of any two out of three pleuroscopic patterns for TB pleurisy were 100.0% and 93.7%, respectively. Conclusions: A high positive predictive value for TB pleurisy was demonstrated by the presence of any two out of the three characteristic features. Absence of all three features had an excellent negative predictive value for TB pleurisy. Our diagnostic criteria reconfirm that pleuroscopic images can be used as predictors for TB pleurisy.

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Comparison of Diagnostic Yield and Safety between Semirigid Pleuroscopic Cryobiopsy and Forceps Biopsy for Undiagnosed Pleural Effusion

Abstract: For undiagnosed pleural effusion, diagnostic yields and safety were similar between pleuroscopic cryobiopsy and forceps biopsy, but cryobiopsy obtained a larger pleural tissue sample than forceps biopsy.

Cited by 6 publications

References 21 publications

Efficacy and Safety of Pleural Cryobiopsy vs. Forceps Biopsy for Evaluation of Undiagnosed Pleural Effusion: A Systematic Review and Meta-Analysis

Efficacy and Safety of Pleural Cryobiopsy vs. Forceps Biopsy for Evaluation of Undiagnosed Pleural Effusion: A Systematic Review and Meta-Analysis

Comparative Study of Aspiration Cytology, Video-Assisted Thoracoscope and Open Biopsy in Undiagnosed Pleural Effusion

Diagnosis of Tuberculosis Pleurisy with Three Endoscopic Features via Pleuroscopy

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