Intra-patient comparison of parietal pleural biopsies by rigid forceps, flexible forceps and cryoprobe obtained during medical thoracoscopy: a prospective series of 80 cases with pleural effusion

BMC Pulmonary Medicine

Research Article

R. Sauer¹  S. Griff¹  T. Mairinger¹  N. Schönfeld²  M. Bock²  C. Duve²  T. T. Bauer²  H. Wurps² 

[1] Department of Pneumology and Institute of Pathology, HELIOS Klinikum Emil von Behring, Berlin, Germany;Department of Respiratory Medicine, Lungenklinik Heckeshorn, HELIOS Klinikum Emil von Behring, Berlin, Germany;

关键词: Medical thoracoscopy;    Cryobiopsy;    Parietal pleura;    Rigid forceps biopsy;    Flexible forceps biopsy;   

DOI  :  10.1186/s12890-016-0258-5

 received in 2016-04-06, accepted in 2016-06-06,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundThere is only few data available on the use of cryotechnique during medical thoracoscopy.MethodsMedical thoracoscopy was performed in consecutive patients with pleural effusion. Prospectively, biopsies were taken by rigid forceps, flexible forceps and cryoprobe. Specimen size, depth and diagnostic yield were compared.Results80 Patients were included. 408 biopsies were taken (205 rigid biopsies, 104 flexible biopsies, 99 cryobiopsies). Mean surface area of rigid biopsies was 22.6 ± 20.4 mm2 (flexible biopsies: 7.1 ± 9.3 mm2, cryobiopsies: 14.4 ± 12.8 mm2). Rigid biopsies were significantly larger than cryobiopsies (p < 0.001) and flexible biopsies (p < 0.001), crybiopsies were significantly larger than flexible biopsies (p < 0.01). A deep biopsy containing fatty tissue was harvested in 63 % of rigid biopsies (cryobiopsy: 49.5 % flexible biopsy: 39.5 %). In 79/80 cases (98.7 % 95 % CI cannot be calculated) a diagnosis was obtained by rigid biopsy (cryobiopsy: 73/80 cases (91.3 % 95 % CI 86.0 – 96.5 %), flexible biopsy: 74/80 cases (92.5 % 95 % CI 88.6 – 97.4 %)). Diagnostic yield achieved with cryobiopsies was inferior to the yield of rigid biopsies (Difference: 12.7 %), but non-inferior to flexible biopsies (Difference: 6.5 %).ConclusionCryobiopsies in medical thoracoscopy are safe with high diagnostic yield, non-inferior to flexible biopsies with increased tissue quantity and quality. Cryotechnique can develop an important role in medical thoracoscopy in the near future when rigid thoracoscopy is not available.

【 授权许可】

CC BY   
© The Author(s). 2016