Transbronchial cryobiopsy in interstitial lung disease

safety of a standardized procedure

Shelley She, Daniel P. Steinfort, Alvin J. Ing, Jonathan P. Williamson, Paul Leong, Louis B. Irving, Barton R. Jennings, Tajalli Saghaie*

*Corresponding author for this work

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Background: Transbronchial lung cryobiopsy (TBCB) plays an increasing role in the evaluation of diffuse parenchymal lung disease with acceptable diagnostic yield and safety profile compared with that of video-assisted thoracoscopic surgical lung biopsy on most reports. However, published outcomes with regard to safety and complication rates vary. We aim to determine the safety profile of TBCB when performed using a standardized protocol consistent with recently published expert guidelines. Materials and Methods: We reviewed prospectively maintained databases from 5 Australian tertiary referral centers. The procedures were performed in accordance with a recent expert statement recommending standardization of TBCB procedures, in particular with fluoroscopy, a secured airway, and prophylactic bronchial blockers. Periprocedural complications were assessed along with clinical outcomes. Results: A total of 121 patients underwent TBCB between August 2013 and August 2017 following a standardized protocol using general anesthesia. Of them, 84 patients (66.7%) were discharged on the day of the procedure. Pneumothorax occurred in 18 patients (14.9%), 13 (10.7%) of whom required chest tube drainage. Moderate bleeding occurred in 15 patients (13.2%) and severe bleeding in 1 (0.83%). Histopathologic diagnosis was made in 80 patients (66.1%). Conclusion: Pooled outcomes from Australian tertiary centers indicate that TBCB is safe when performed in a protocolized fashion. Active measures to anticipate and manage bleeding and to direct biopsy position result in low rates of major complications.

Original languageEnglish
Pages (from-to)36-41
Number of pages6
JournalJournal of Bronchology and Interventional Pulmonology
Volume27
Issue number1
Early online date13 Nov 2019
DOIs
Publication statusPublished - Jan 2020

Keywords

  • interstitial lung disease
  • safety
  • transbronchial cryobiopsy

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