Sriprasart Thitiwat, Aragaki Alejandro, Baughman Robert, Wikenheiser-Brokamp Kathryn, Khanna Gaurav, Tanase Daniel, Kirschner Michelle, Benzaquen Sadia
*Department of Internal Medicine, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, Bangkok, Thailand †Division of Pulmonary, Critical Care and Sleep Medicine, University of Cincinnati Medical Center ‡Division of Pathology and Laboratory Medicine, and Perinatal Institute, Division of Pulmonary Biology, Cincinnati Children's Hospital Medical Center, and Department of Pathology and Laboratory Medicine, University of Cincinnati, Cincinnati, OH.
J Bronchology Interv Pulmonol. 2017 Apr;24(2):131-135. doi: 10.1097/LBR.0000000000000366.
Transbronchial lung cryobiopsy (TBLC) has been used to establish the diagnosis of interstitial lung disease (ILD) in recent years. The technique and diagnostic yield vary among institutions. We report a new 2-scope technique and the results of TBLC in our institution.
This is a retrospective chart review of patients who underwent TBLC for evaluation of ILD. Bronchoscopy with TBLC was performed by a board-certified interventional pulmonologist with a 2-scope technique under general anesthesia.
A total of 74 patients underwent TBLC with a 2-scope technique. Their mean age was 54±14 years. The mean tissue surface area was 63.54±6.76 mm. The average anesthesia time was 80.66 minutes. The diagnostic yield was 87.84%. The most common diagnosis was sarcoidosis pneumothorax, which occurred in 5 cases (7%). There was 1 case with bronchoscopic-related respiratory failure associated with significant bleeding. Death occurred in 3 cases (4%), which is comparable to recent mortality data for "elective" surgical lung biopsy for ILD (1.7% to 4.2%).
TBLC with a 2-scope technique could be an alternative method for diagnosing various types of ILD in patients unfit for surgical lung biopsy. Further prospective studies should clarify its role in the diagnostic armamentarium for undiagnosed ILDs.
近年来，经支气管肺冷冻活检（TBLC）已被用于间质性肺疾病（ILD）的诊断。各机构的技术和诊断率有所不同。我们报告了一种新的双镜技术以及我们机构中TBLC的结果。
这是一项对因评估ILD而接受TBLC的患者进行的回顾性病历审查。TBLC支气管镜检查由一名获得委员会认证的介入肺科医生在全身麻醉下采用双镜技术进行。
共有74例患者采用双镜技术进行了TBLC。他们的平均年龄为54±14岁。平均组织表面积为63.54±6.76平方毫米。平均麻醉时间为80.66分钟。诊断率为87.84%。最常见的诊断是结节病气胸，共5例（7%）。有1例与支气管镜相关的呼吸衰竭并伴有大量出血。3例（4%）死亡，这与近期“择期”手术肺活检诊断ILD的死亡率数据（1.7%至4.2%）相当。
双镜技术的TBLC可能是诊断不适合手术肺活检患者各种类型ILD的一种替代方法。进一步的前瞻性研究应阐明其在未确诊ILD诊断手段中的作用。
