Bango-Álvarez Antonio, Ariza-Prota Miguel, Torres-Rivas Hector, Fernández-Fernández Luis, Prieto Amador, Sánchez Inmaculada, Gil Maria, Pando-Sandoval Ana
Division of Respiratory Medicine, Hospital Universitario Central de Asturias, Oviedo, Spain.
Division of Pathology, Hospital Universitario Central de Asturias, Oviedo, Spain.
ERJ Open Res. 2017 Mar 22;3(1). doi: 10.1183/23120541.00148-2016. eCollection 2017 Jan.
Transbronchial biopsy using forceps (TBB) is the first diagnostic technique performed on patients with interstitial lung disease (ILD). However, the small size of the samples and the presence of artefacts in the tissue obtained make the yield variable. Our objectives were 1) to attempt to reproduce transbronchial cryobiopsy under the same conditions with which we performed conventional TBB, that is, in the bronchoscopy unit without intubating the patient and without fluoroscopy or general anaesthesia; 2) to describe the method used for its execution; and 3) to analyse the diagnostic yield and its complications. We carried out a prospective study that included 106 patients with clinical and radiological features suggestive of ILD who underwent cryo-transbronchial lung biopsy (cryo-TBB) under moderate sedation without endotracheal intubation, general anaesthesia or use of fluoroscopy. We performed the procedure using two flexible bronchoscopes connected to two video processors, which we alternated until obtaining the number of desired samples. A definitive diagnosis was obtained in 91 patients (86%). As for complications, there were five pneumothoraces (4.7%) and in no case was there severe haemorrhage or exacerbation of the underlying interstitial disease. Cryo-TBB following our method is a minimally invasive, rapid, safe and economic technique that can be performed in a bronchoscopy suite under moderate sedation without the need for intubating the patient or using fluoroscopy and without requiring general anaesthesia.
使用活检钳进行的经支气管活检(TBB)是间质性肺疾病(ILD)患者首先采用的诊断技术。然而,所获取样本的体积较小以及组织中存在人为假象,使得活检的成功率存在差异。我们的目标是:1)尝试在与进行传统TBB相同的条件下重现经支气管冷冻活检,即在支气管镜检查室进行,不插管、不使用荧光透视或全身麻醉;2)描述实施该检查所采用的方法;3)分析诊断成功率及其并发症。我们开展了一项前瞻性研究,纳入了106例具有临床和影像学特征提示ILD的患者,这些患者在中度镇静下接受了冷冻经支气管肺活检(cryo-TBB),未进行气管插管、全身麻醉或使用荧光透视。我们使用连接到两个视频处理器的两台柔性支气管镜进行操作,交替使用直至获取所需数量的样本。91例患者(86%)获得了明确诊断。至于并发症,有5例气胸(4.7%),无一例出现严重出血或基础间质性疾病加重。按照我们的方法进行的cryo-TBB是一种微创、快速、安全且经济的技术,可在支气管镜检查室在中度镇静下进行,无需患者插管或使用荧光透视,也无需全身麻醉。
Sarcoidosis Vasc Diffuse Lung Dis. 2016-3-29
Indian J Tuberc. 2021-1
Respiration. 2018-6-12
J Clin Med. 2024-11-23
Medicine (Baltimore). 2024-7-19
Open Respir Arch. 2022-12-5
Sarcoidosis Vasc Diffuse Lung Dis. 2022
J Bronchology Interv Pulmonol. 2016-1
N Engl J Med. 2014-5-18