Comparative study of cryorecanalisation and cryoablation using flexible bronchoscopy for the treatment of endobronchial tuberculosis

Updates Surg. 2024 Dec 13. doi: 10.1007/s13304-024-02031-x. Online ahead of print.

Abstract

To compare the efficacy and safety of cryorecanalisation and cryoablation using flexible bronchoscopy for the treatment of tumor-like endobronchial tuberculosis (EBTB). Patients with tumor-like EBTB (104) were randomly divided into a cryorecanalisation (54 patients) or cryoablation (50 patients) group to assess the differences in efficacy and complications between the treatments. The cryorecanalisation and cryoablation treatments' therapeutic efficacies were 81.5% and 48.0%, respectively (p = 0.000); in patients with less than moderate obstruction (≤ 50%), the therapeutic efficacies were 92.9% and 88.9%, respectively (p = 1.000). In patients with more than moderate obstruction (> 50%), cryorecanalisation and cryoablation's therapeutic efficacies were 77.5% and 25.0%, respectively (p = 0.000). The number of treatments in the cryorecanalisation and cryoablation groups were 2.46 ± 1.06 and 3.26 ± 0.75, respectively (p = 0.000). The main complication of the treatment protocol in both groups was bleeding, and the overall bleeding rate was 96.2% and 16.0% in the cryorecanalisation and cryoablation groups, respectively (p = 0.000). Cryorecanalisation via flexible bronchoscopy improved the outcome of patients with tumor-like EBTB and reduced the number of treatments required compared with cryoablation; however, it had a higher bleeding rate and the potential risk of severe bleeding.

Keywords: Cryorecanalisation; Endobronchial tuberculosis; Flexible bronchoscopy.