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前瞻性对照动物研究:新型柔性冷冻探针与活检钳活检采样的对比:评估活检样本大小、组织学质量和出血风险。

Prospective controlled animal study on biopsy sampling with new flexible cryoprobes versus forceps: evaluation of biopsy size, histological quality and bleeding risk.

机构信息

Department of Pneumology and Critical Care Medicine, Helios Klinik Ambrock, University of Witten/Herdecke, Hagen, Germany.

出版信息

Respiration. 2010;80(2):127-32. doi: 10.1159/000287251. Epub 2010 Feb 17.

Abstract

BACKGROUND

Cryoextraction is a procedure used for the recanalization of obstructed airways caused by visible exophytic endobronchial tumor. Biopsy samples obtained by this technique have been shown to be useful for histological assessment.

OBJECTIVES

The aim of the present animal study was to systematically evaluate biopsy size, histological quality and bleeding risk after cryobiopsy with new, flexible cryoprobes in comparison with forceps biopsy, serving as the gold standard.

METHODS

Biopsies were obtained from anesthetized pigs with the flexible bronchoscopy technique, and evaluated histologically with respect to their size and quality. Bleeding frequency, bleeding duration and histological changes in the biopsy bed were also recorded.

RESULTS

Cryobiopsies were significantly larger than forceps biopsies. The size of cryobiopsies was dependent on the freezing time. The histological quality of the cryobiopsy specimenswas not impaired by the freezing process, whereas forceps biopsies showed typical crush artifacts. Despite the larger defects left in the tracheobronchial system after cryobiopsy, bleeding frequency and duration were not higher compared to forceps biopsy.

CONCLUSIONS

Since cryobiopsy sampling is not associated with a higher bleeding risk compared with forceps biopsy, this new biopsy technique offers--in addition to a good specimen quality--a safe and valuable tool with the potential of improving the outcome of diagnostic endoscopy.

摘要

背景

冷冻切除术是一种用于复通由可见外生型支气管内肿瘤引起的气道阻塞的程序。通过该技术获得的活检样本已被证明可用于组织学评估。

目的

本动物研究的目的是系统地评估新型柔性冷冻探针与活检钳相比在冷冻活检时的活检大小、组织学质量和出血风险,活检钳作为金标准。

方法

使用柔性支气管镜技术从麻醉猪身上获取活检,并评估其大小和质量。还记录了出血频率、出血持续时间和活检床上的组织学变化。

结果

冷冻活检明显大于活检钳活检。冷冻活检的大小取决于冷冻时间。冷冻活检标本的组织学质量不受冷冻过程的影响,而活检钳活检显示典型的挤压伪影。尽管冷冻活检后在气管支气管系统中留下的缺陷较大,但与活检钳相比,出血频率和持续时间并没有更高。

结论

由于冷冻活检与活检钳相比不会增加出血风险,因此这种新的活检技术除了具有良好的标本质量外,还提供了一种安全且有价值的工具,有可能改善诊断性内镜的结果。

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