Journal of bronchology & interventional pulmonology · 2025
Safety and Diagnostic Yield of Transbronchial Cryobiopsy by Flexible Bronchoscopy Under Conscious Sedation Without Intubation in Diffuse Parenchymal Lung Disease.
СтатьяНазвание и аннотация: Перевод в очереди
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Chen Yifan, Liu Yang, Zhu Hao, Wang Zeqiang, Liu Wei
Аннотация
BACKGROUND: Transbronchial cryobiopsy (TBCB) is generally recommended under intubation or rigid bronchoscopy with general anesthesia. However, some patients with diffuse parenchymal lung disease (DPLD) are unable to tolerate general anesthesia, which limits the widespread adoption of TBCB.
METHODS: A total of 37 patients with DPLD who underwent TBCB under conscious sedation without intubation were included in this study. The procedures of TBCB were under conscious sedation without intubation, combining with radial probe-endobronchial ultrasound (RP-EBUS) and a prophylactic positioned endobronchial balloon. Specimen diameter, pathologic specimen quality, pathologic and multidisciplinary discussion (MDD) diagnosis yield, and complications were recorded.
RESULTS: Adequate pathologic specimens were obtained in 36 of 37 patients (97.3%), yielding a total of 159 samples with an average diameter of 4.28±1.14 mm. A definitive diagnosis was established in 26 patients (70.3%) through histopathology and MDD. In 8 patients (21.6%), although histopathologic diagnosis was not achieved, TBCB provided valuable information that contributed to a final diagnosis through MDD and follow-up. Three cases (8.1%) failed to make a definitive diagnosis. Six (16.2%) cases developed pneumothorax. The bleeding volume was 9.5±6.7 mL/case, with no instances of severe bleeding requiring surgical or interventional embolization.
CONCLUSION: TBCB performed with RP-EBUS and balloon blockade under conscious sedation is safe and effective for patients with DPLD.
METHODS: A total of 37 patients with DPLD who underwent TBCB under conscious sedation without intubation were included in this study. The procedures of TBCB were under conscious sedation without intubation, combining with radial probe-endobronchial ultrasound (RP-EBUS) and a prophylactic positioned endobronchial balloon. Specimen diameter, pathologic specimen quality, pathologic and multidisciplinary discussion (MDD) diagnosis yield, and complications were recorded.
RESULTS: Adequate pathologic specimens were obtained in 36 of 37 patients (97.3%), yielding a total of 159 samples with an average diameter of 4.28±1.14 mm. A definitive diagnosis was established in 26 patients (70.3%) through histopathology and MDD. In 8 patients (21.6%), although histopathologic diagnosis was not achieved, TBCB provided valuable information that contributed to a final diagnosis through MDD and follow-up. Three cases (8.1%) failed to make a definitive diagnosis. Six (16.2%) cases developed pneumothorax. The bleeding volume was 9.5±6.7 mL/case, with no instances of severe bleeding requiring surgical or interventional embolization.
CONCLUSION: TBCB performed with RP-EBUS and balloon blockade under conscious sedation is safe and effective for patients with DPLD.