Background In recent years, transbronchial cryobiopsy (TBCB) has come to be increasingly used in interventional pulmonology units as it obtains larger and better-quality samples than conventional transbronchial lung biopsy (TBLB) with forceps. No multicenter studies have been performed, however, that analyse and compare TBCB and TBLB safety and yield according to the interstitial lung disease (ILD) classification. Objectives We compared the diagnostic yield and safety of TBCB with cryoprobe sampling versus conventional TBLB forceps sampling in the same patient. Method Prospective multicenter clinical study of patients with ILD indicated for lung biopsy. Airway management with orotracheal tube, laryngeal mask and rigid bronchoscope was according to the protocol of each centre. All procedures were performed using fluoroscopy and an occlusion balloon. TBLB was followed by TBCB. Complications were recorded after both TBLB and TBCB. Results Included were 124 patients from 10 hospitals. Airway management was orotracheal intubation in 74% of cases. Diagnostic yield according to multidisciplinary committee results for

BackgroundEndobronchial ultrasound guided transbronchial needle aspiration (EBUS-TBNA) is the technique of choice in the study of mediastinal and hilar lesions; however, it can be affected by the insufficiency of intact biopsy samples, which might decrease its diagnostic yield for certain conditions, thus requiring re-biopsies or additional diagnostic procedures such as mediastinoscopy when probability of malignancy remains high.ObjectivesOur objectives were to 1) attempt to reproduce this technique in the same conditions that we performed EBUS-TBNA, that is, in the bronchoscopy suite and under moderate sedation; 2) describe the method used for its execution; 3) determine its feasibility by accessing different lymph node stations applying our method; 4) analyze the diagnostic yield and its complications.MethodsProspective study of 50 patients who underwent EBUS-TBNA and EBUS-guided TMC in a single procedure using a 22-G TBNA needle and a 1.1 mm cryo-probe subsequently between January and August 2022. Patients with mediastinal lesions greater than 1 cm were recruited and EBUS-TBNA and TMC were performed in the same lymph node station.ResultsThe diagnostic yield was 82% and 96% for TBNA and transbronchial mediastinal cryobiopsy, respectively. Diagnostic yields were similar for sarcoidosis, while cryobiopsy was more sensitive than TBNA in lymphomas and metastatic lymph nodes. As for complications, there was no pneumothorax and in no case was there significant bleeding. There were no complications during the procedure or in the follow-up of these patients.ConclusionsTMC following our method is a minimally invasive, rapid, and safe technique that can be performed in a bronchoscopy suite under moderate sedation, with a higher diagnostic yield than EBUS-TBNA, especially in cases of lymphoproliferative disorders and mestastatic lymph nodes, or when more biopsy sample is needed for molecular determinations.

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