Ultrathin bronchoscopic cryobiopsy of peripheral pulmonary lesions. Issue 2 (6th September 2022)

• Record Type: Journal Article
• Authors: Oki, Masahide; Saka, Hideo; Kogure, Yoshihito; Niwa, Hideyuki; Yamada, Arisa; Torii, Atsushi; Kitagawa, Chiyoe
• Is Part Of: Respirology. Volume 28:Issue 2(2023)
• Page Start: 143
• Page End: 151
• Publication Date: 2022-09-06
• Subjects: bleeding -- bronchoscopy -- cryobiopsy -- cryoprobe -- ultrathin bronchoscope; Respiratory organs -- Diseases -- Periodicals; Respiratory organs -- Periodicals; 612.2
• DOI: 10.1111/resp.14360
• Languages: English
• ISSNs: 1323-7799

Abstract

Abstract: Background and Objective: Ultrathin bronchoscopy aids in the diagnosis of peripheral pulmonary lesions. However, both the working channel and the specimens are small. A 1.1‐mm ultrathin cryoprobe that can enter the working channel of the ultrathin bronchoscope is now available, which may overcome the limitations of small specimen size. The aim of this study was to evaluate the feasibility, efficacy and safety of ultrathin bronchoscopic cryobiopsy using an ultrathin cryoprobe for diagnosing peripheral pulmonary lesions. Methods: Patients with peripheral pulmonary lesions ≤30 mm in diameter were prospectively enrolled in the study. All patients underwent forceps biopsy followed by cryobiopsy using a 3.0‐mm ultrathin bronchoscope under radial probe endobronchial ultrasound guidance, virtual bronchoscopic navigation and fluoroscopic guidance. The primary endpoint was the feasibility of cryobiopsy. Results: In total, 50 patients with peripheral pulmonary lesions were enrolled in the study; the median longest diameter on computed tomography was 17.9 mm. Cryobiopsy was performed successfully in 49 patients (98%). Forceps biopsy, cryobiopsy and the combination of these two methods provided a specific diagnosis in 54% (27/50), 62% (31/50) and 74% (37/50) of patients, respectively. The median size of specimens obtained via cryobiopsy was significantly larger than the median size obtained via forceps biopsy (7.0 vs. 1.3 mm 2, respectively, p < 0.001). Mild bleeding during cryobiopsy occurred in 47 patients (94%). No moderate/severe bleeding or pneumothorax occurred. Conclusion: Ultrathin bronchoscopic cryobiopsy is feasible, effective and sufficiently safe for the diagnosis of peripheral pulmonary lesions. Abstract : To date, no prospective study has evaluated the use of a 1.1‐mm ultrathin cryoprobe in combination with ultrathin bronchoscopy. Ultrathin bronchoscopic cryobiopsy was successfully performed in most of our patients without any significant complications, which enhanced the overall diagnostic yield when combined with forceps biopsy. See related Editorial