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

Research output: Contribution to journalArticleResearchpeer-review

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.

LanguageEnglish
Pages36-41
Number of pages6
JournalJournal of Bronchology and Interventional Pulmonology
Volume27
Issue number1
Early online date13 Nov 2019
DOIs
Publication statusPublished - Jan 2020

Fingerprint

Interstitial Lung Diseases
Safety
Lung
Hemorrhage
Biopsy
Chest Tubes
Fluoroscopy
Pneumothorax
Tertiary Care Centers
General Anesthesia
Drainage
Databases
Guidelines

Keywords

  • interstitial lung disease
  • safety
  • transbronchial cryobiopsy

Cite this

She, Shelley ; Steinfort, Daniel P. ; Ing, Alvin J. ; Williamson, Jonathan P. ; Leong, Paul ; Irving, Louis B. ; Jennings, Barton R. ; Saghaie, Tajalli. / Transbronchial cryobiopsy in interstitial lung disease : safety of a standardized procedure. In: Journal of Bronchology and Interventional Pulmonology. 2020 ; Vol. 27, No. 1. pp. 36-41.
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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.",
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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 journalArticleResearchpeer-review

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