Feasibility and Safety of Pleuroscopic Cryobiopsy of the Pleura: A Prospective Study

Chia-Hung Chen, Wen-Chien Cheng, Biing-Ru Wu, Chih-Yu Chen, Wei-Chun Chen, Wei-Chih Liao, Chih-Yen Tu, Chia-Hung Chen, Wen-Chien Cheng, Biing-Ru Wu, Chih-Yu Chen, Wei-Chun Chen, Wei-Chih Liao, Chih-Yen Tu

Abstract

Background: The aim of this study was thus to evaluate the feasibility and safety of taking biopsy specimens by cryoprobe from the parietal pleura during semirigid pleuroscope.

Methods: In a single-center, observational, prospective study, patients with exudative pleural effusion (EPE) were evaluated with a semirigid pleuroscope between January 2015 and July 2017. Each patient underwent pleural biopsy using flexible forceps and flexible cryoprobe through pleuroscope following diagnostic thoracentesis and closed pleural biopsy (CPB).

Results: A total of 92 patients (median age 64 years) were included in the study, most of whom were men (65.2%). Cytological cell block (CCB) and CPB made definitive diagnoses in 32/92 (34.8%) and 25/92 (27.5%), respectively; flexible forceps biopsy (FFB) and cryoprobe biopsy (CB) established definitive diagnoses in 84/92 (91.3%) and 91/92 (98.9%), respectively. The sample obtained by CB (9.4 ± 4.9 mm) was significantly larger than the other two methods: FFB (4.2 ± 2.3 mm) or CPB (1.9 ± 1.0 mm) (P < 0.0001). The immunohistochemical (IHC) staining was more easily performed with CB (98.9%) compared to either FFB (87.0%) or CPB (13.0%). There were no significant complications or procedure-related deaths.

Conclusions: Based on these results, CB during semirigid pleuroscope has a high diagnostic yield, differentiating EPE of unknown etiology with satisfactory effectiveness and safety.

Figures

Figure 1
Figure 1
(a) Semirigid pleuroscope; (b) flexible forceps; (c) Abram's needle; (d) flexible cryoprobe.
Figure 2
Figure 2
The pleural biopsy obtained by CB had larger tissue size with better tissue integrity compared to the other two methods.
Figure 3
Figure 3
The sample obtained by CB (9.1 ± 4.5 mm) was significantly bigger than the other two methods: FFB (4.0 ± 2.1 mm) or CPB (1.9 ± 1.0 mm) (P < 0.0001).

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Source: PubMed

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