Ravi Ajay, Deshpande Anurag, Ramasubramaniam K, Aggarwal Manish, Goyal Rajiv
Department of Respiratory Medicine, Caritas Hospital, Kottayam, Kerala, India.
Department of Respiratory Medicine, Fortis Hospital, Noida, Uttar Pradesh, India.
Lung India. 2022 Jan-Feb;39(1):34-37. doi: 10.4103/lungindia.lungindia_373_21.
Pulmonologists commonly need to take biopsies of laryngeal lesions, either found incidentally while doing bronchoscopy for other indications or while investigating patients for hoarseness of voice and cough. Biopsy of laryngeal lesions has been conventionally done under general anesthesia to provide adequate samples and minimize risks and patient discomfort. Of late, these biopsies have been done as outpatient procedures, by flexible endoscopes, under local anesthesia. However, vocal cord biopsies are often challenging due to poor patient compliance. We have tested an innovative method, which we have called the "inside-out" method, to circumvent this problem.
We aimed to analyze the feasibility, yield, and the safety of the "inside-out" technique for taking vocal cord biopsies as an outpatient procedure in awake patients.
This was a prospective observational study. Data of 38 patients with vocal cord lesions in whom the above technique was employed were analyzed.
The procedure had a diagnostic yield of 78.9% with a sensitivity of 96.7% and a specificity of 100% for detecting malignancy or dysplasia. There were no major complications.
The "inside-out" technique was found to be feasible and safe and with a high yield.
肺科医生常常需要对喉部病变进行活检，这些病变要么是在因其他指征进行支气管镜检查时偶然发现的，要么是在对声音嘶哑和咳嗽患者进行检查时发现的。传统上，喉部病变活检是在全身麻醉下进行的，以获取足够的样本并将风险和患者不适降至最低。近来，这些活检已作为门诊手术，通过可弯曲内窥镜在局部麻醉下进行。然而，由于患者配合度差，声带活检往往具有挑战性。我们测试了一种创新方法，我们称之为“由内向外”法，以解决这个问题。
我们旨在分析“由内向外”技术作为清醒患者门诊手术进行声带活检的可行性、取材成功率和安全性。
这是一项前瞻性观察研究。分析了38例采用上述技术的声带病变患者的数据。
该手术的诊断取材成功率为78.9%，检测恶性肿瘤或发育异常的敏感性为96.7%，特异性为100%。无重大并发症。
“由内向外”技术被发现是可行、安全且取材成功率高的。
