Cryobiopsy versus Forceps Biopsy in Endobronchial Lesions, Diagnostic Yield and Safety

Abstract

Introduction: This study aimed to evaluate the safety and diagnostic yield of cryobiopsy (CB) in comparison to forceps biopsy in endobronchial lesions. Material and methods:Patients with suspected endobronchial lesions were enrolled. Two forceps biopsies and one cryobiopsy were done in the same patient with randomized sequence. The largest diameter of the samples was measured in mm by electronic caliper. Diagnostic yield of each technique and postbronchoscopy bleeding were evaluated. Results: Samples obtained by CB was significantly larger than that of the forceps biopsy (5.9 ± 2.3 vs 2.5 ± 0.8, p = 0.001). Diagnostic yield of CB was significantly higher than forceps biopsy 74.5% versus 51.1% (p = 0.001). Mild and moderate bleeding grades were reported in both techniques with no significant difference (p = 0.063, p = 0.5), respectively. Severe bleeding was not recorded in both techniques. Conclusions: CB represents a safe and effective tool to obtain a larger tissue samples of a good quality with higher diagnostic yield in comparison to standard forceps samples. On the other hand, bleeding occurred more frequently after CB than forceps biopsy. However, without severe adverse effects.

Hemorrhage Risk of Patients Receiving Bronchoscope Examination or Treatment

“…However, there was also some reported higher incidence of complications of approximately 5% [14] . For some type of procedure such as cryobiopsy, only the incidence of hemorrhage could reach 42.1% [15,16] . Nearly all of these studies concluded that bronchoscopy is well tolerated, but the speci c incidence of complications of different operations has not been studied in detail.…”

“…There were no standard criteria for the evaluation of the severity of bleeding during bronchoscopy owing to airway secretion mixed with the blood and di culty to quantify. Therefore, we classi ed the severity of bleeding during the procedure into 4 grades [7,8] : grade 0, no bleeding or extremely minimal bleeding that does not require suction; grade 1, mild bleeding that only requires suction; grade 2, bleeding requiring topical instillation of epinephrine or ice-cold saline; grade 3, moderate bleeding that requires pressure via an in ated balloon catheter or intravenous injection of pituitrin; and grade 4, bleeding requiring hemodynamic support, transfusion of blood products, or interventional or surgical therapy. The severity of bleeding associated with the types of operating procedure was also analyzed.…”

Influence of Biopsy Technique on Molecular Genetic Tumor Characterization in Non-Small Cell Lung Cancer—The Prospective, Randomized, Single-Blinded, Multicenter PROFILER Study Protocol

“…Bleeding is the main side effect of bronchoscopic biopsy in visible endobronchial tumors. No difference has been shown in clinically relevant bleeding between FB and CB in prospective trials [ 39 , 74 ].…”

Medical thoracoscopic cryoevacuation: A novel technique to manage retained hemothorax

“…CP has proved to be a valuable addition to the arsenal of interventional pulmonologists and has revolutionized transbronchial and endobronchial biopsies, providing samples comparable to those obtained by surgical means. [1213] The unique freezing property of CP also has facilitated quick evacuation of large endobronchial clots using flexible bronchoscope in patients with respiratory failure. [14] CP has also demonstrated that larger specimens are obtained compared to those by forceps when used for taking parietal pleural biopsies.…”