A Single US Center Experience of Transbronchial Lung Cryobiopsy for Diagnosing Interstitial Lung Disease With a 2-Scope Technique

J Bronchology Interv Pulmonol. 2017 Apr;24(2):131-135. doi: 10.1097/LBR.0000000000000366.

Abstract

Background: Transbronchial lung cryobiopsy (TBLC) has been used to establish the diagnosis of interstitial lung disease (ILD) in recent years. The technique and diagnostic yield vary among institutions. We report a new 2-scope technique and the results of TBLC in our institution.

Methods: This is a retrospective chart review of patients who underwent TBLC for evaluation of ILD. Bronchoscopy with TBLC was performed by a board-certified interventional pulmonologist with a 2-scope technique under general anesthesia.

Results: A total of 74 patients underwent TBLC with a 2-scope technique. Their mean age was 54±14 years. The mean tissue surface area was 63.54±6.76 mm. The average anesthesia time was 80.66 minutes. The diagnostic yield was 87.84%. The most common diagnosis was sarcoidosis pneumothorax, which occurred in 5 cases (7%). There was 1 case with bronchoscopic-related respiratory failure associated with significant bleeding. Death occurred in 3 cases (4%), which is comparable to recent mortality data for "elective" surgical lung biopsy for ILD (1.7% to 4.2%).

Conclusion: TBLC with a 2-scope technique could be an alternative method for diagnosing various types of ILD in patients unfit for surgical lung biopsy. Further prospective studies should clarify its role in the diagnostic armamentarium for undiagnosed ILDs.

MeSH terms

  • Adult
  • Aged
  • Biopsy
  • Bronchoscopy / adverse effects
  • Bronchoscopy / instrumentation*
  • Cryosurgery / adverse effects
  • Cryosurgery / instrumentation*
  • Female
  • Humans
  • Lung Diseases, Interstitial / diagnosis*
  • Male
  • Middle Aged
  • Prospective Studies
  • Retrospective Studies
  • Thoracic Surgery, Video-Assisted / adverse effects
  • Thoracic Surgery, Video-Assisted / instrumentation