Cryoprobe transbronchial lung biopsy: How we do it?

Madan, Karan; Mittal, Saurabh; Gupta, Nishkarsh; Hadda, Vijay; Guleria, Randeep

doi:10.4103/lungindia.lungindia_52_17

Cited by 8 publications

(7 citation statements)

References 5 publications

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“…The cryoprobe is then removed from the bronchoscope and then the bronchoscope is reintroduced to check for any active bleeding. After excluding any significant airway bleeding, suction is performed to remove any spilt over blood and the bronchoscope is removed from the airway [ 5 ]. An endobronchial balloon blocker was kept prepared in the operation room as it would be accessible to manage bleeding during the lung biopsy.…”

Section: Methodsmentioning

confidence: 99%

Diagnostic Yield and Safety of Bronchoscopic Lung Cryobiopsy in Evaluation of Lung Mass

Ps¹,

Marwah²,

Katoch³

et al. 2021

Cureus

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BackgroundA mass lesion in the lung is a common finding seen on chest radiology. The prognosis of patients with mass lesions in the lung is capricious as malignancy is a consideration. It is essential to diagnose the underlying aetiology at the earliest with minimally invasive procedures for prompt treatment of the case. Bronchoscopic lung cryobiopsy (BLC) is a newer interventional technique in pulmonary medicine for the diagnosis of mass lesions in the lung. Materials and methodsThis is a retrospective study of patients reporting to a tertiary care centre who were radiologically (by computed tomography scan of the chest) diagnosed with a mass lesion of the lung and who underwent BLC during the period from January 2018 to January 2021. We analysed the diagnostic yield of the technique defined as a positive tissue diagnosis after the histopathological examination (HPE) along with the safety of the procedure. ResultsDuring the above period, we evaluated 70 patients who were diagnosed radiologically with mass lesions of the lung and underwent BLC. We obtained tissue diagnoses for 66 cases and the result of four cases was inconclusive. The diagnostic yield of the BLC procedure was 94.29%. There was no mortality and complications were minimal bleeding and small pneumothorax. ConclusionBLC is a newer technique for obtaining lung tissue via a flexible bronchoscope obviating the need for open lung biopsy. The main advantage of the technique is providing larger tissue samples with minimal or no side effects without undergoing multiple procedures as compared to other bronchoscopic or surgical methods for obtaining a diagnosis from lung tissue. BLC is a safer and promising technique in diagnosing mass lesions of the lung with better yield.

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Section: Methodsmentioning

confidence: 99%

Diagnostic Yield and Safety of Bronchoscopic Lung Cryobiopsy in Evaluation of Lung Mass

Ps¹,

Marwah²,

Katoch³

et al. 2021

Cureus

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show abstract

“…[19] Fourth, if an AA is not used, the patient has to be maintained in a lighter plane of anesthesia that may be associated with vigorous coughing, thus increasing the chance of slippage of the occlusion balloon (OB). [58]…”

Section: Methodsmentioning

confidence: 99%

Bronchoscopic lung cryobiopsy: An Indian association for bronchology position statement

et al. 2019

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Background: Bronchoscopic lung cryobiopsy (BLC) is a novel technique for obtaining lung tissue for the diagnosis of diffuse parenchymal lung diseases. The procedure is performed using several different variations of technique, resulting in an inconsistent diagnostic yield and a variable risk of complications. There is an unmet need for standardization of the technical aspects of BLC. Methodology: This is a position statement framed by a group comprising experts from the fields of pulmonary medicine, thoracic surgery, pathology, and radiology under the aegis of the Indian Association for Bronchology. Sixteen questions on various technical aspects of BLC were framed. A literature search was conducted using PubMed and EMBASE databases. The expert group discussed the available evidence relevant to each question through e-mail and a face-to-face meeting, and arrived at a consensus. Results: The experts agreed that patients should be carefully selected for BLC after weighing the risks and benefits of the procedure. Where appropriate, consideration should be given to perform alternate procedures such as conventional transbronchial biopsy or subject the patient directly to a surgical lung biopsy. The procedure is best performed after placement of an artificial airway under sedation/general anesthesia. Fluoroscopic guidance and occlusion balloon should be utilized for positioning the cryoprobe to reduce the risk of pneumothorax and bleeding, respectively. At least four tissue specimens (with at least two of adequate size, i.e., ≥5 mm) should be obtained during the procedure from different lobes or different segments of a lobe. The histopathological findings of BLC should be interpreted by an experienced pulmonary pathologist. The final diagnosis should be made after a multidisciplinary discussion. Finally, there is a need for structured training for performing BLC. Conclusion: This position statement is an attempt to provide practical recommendations for the performance of BLC in DPLDs.

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“…The size of biopsy pieces ranged from 6 to 9 mm and was similar to the biopsies we obtain using rigid bronchoscopic cryoprobe TBLB. [ 2 ] The procedure was performed in two patients, and no complications occurred. Thoracic ultrasound was performed on site in both the patients following biopsy and excluded pneumothorax.…”

Section: Techniquementioning

confidence: 99%

“…[ 1 ] Guidelines on patient selection and technical aspects of this modality are yet not standardized, and a variety of modalities have been described. [ 2 ] Exclusive use of a flexible bronchoscope may allow the performance of this procedure, but without the use of an occlusion balloon, this may be associated with unpredictable severe bleeding. [ 3 4 ] Some authors have reported the use of single flexible bronchoscope while others have used two flexible bronchoscopes in sequential manner or rendezvous method.…”

Section: Introductionmentioning

confidence: 99%

Cryoprobe transbronchial lung biopsy with flexible bronchoscope using Arndt endobronchial blocker

2019

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Cryoprobe transbronchial lung biopsy: How we do it?

Cited by 8 publications

References 5 publications

Diagnostic Yield and Safety of Bronchoscopic Lung Cryobiopsy in Evaluation of Lung Mass

Diagnostic Yield and Safety of Bronchoscopic Lung Cryobiopsy in Evaluation of Lung Mass

Bronchoscopic lung cryobiopsy: An Indian association for bronchology position statement

Cryoprobe transbronchial lung biopsy with flexible bronchoscope using Arndt endobronchial blocker

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