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.
| Language | English |
|---|---|
| Pages | 36-41 |
| Number of pages | 6 |
| Journal | Journal of Bronchology and Interventional Pulmonology |
| Volume | 27 |
| Issue number | 1 |
| Early online date | 13 Nov 2019 |
| DOIs | |
| Publication status | Published - Jan 2020 |
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Keywords
- interstitial lung disease
- safety
- transbronchial cryobiopsy
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}
Transbronchial cryobiopsy in interstitial lung disease : safety of a standardized procedure. / She, Shelley; Steinfort, Daniel P.; Ing, Alvin J.; Williamson, Jonathan P.; Leong, Paul; Irving, Louis B.; Jennings, Barton R.; Saghaie, Tajalli.
In: Journal of Bronchology and Interventional Pulmonology, Vol. 27, No. 1, 01.2020, p. 36-41.Research output: Contribution to journal › Article › Research › peer-review
TY - JOUR
T1 - Transbronchial cryobiopsy in interstitial lung disease
T2 - Journal of Bronchology and Interventional Pulmonology
AU - She, Shelley
AU - Steinfort, Daniel P.
AU - Ing, Alvin J.
AU - Williamson, Jonathan P.
AU - Leong, Paul
AU - Irving, Louis B.
AU - Jennings, Barton R.
AU - Saghaie, Tajalli
PY - 2020/1
Y1 - 2020/1
N2 - 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.
AB - 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.
KW - interstitial lung disease
KW - safety
KW - transbronchial cryobiopsy
UR - http://www.scopus.com/inward/record.url?scp=85075361372&partnerID=8YFLogxK
U2 - 10.1097/LBR.0000000000000633
DO - 10.1097/LBR.0000000000000633
M3 - Article
VL - 27
SP - 36
EP - 41
JO - Journal of Bronchology and Interventional Pulmonology
JF - Journal of Bronchology and Interventional Pulmonology
SN - 1944-6586
IS - 1
ER -