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通过径向超声支气管镜引导鞘管使用1.1毫米冷冻探头(无需支气管封堵器)在诊断肺外周病变时安全获取样本。

Use of the 1.1 mm cryoprobe through the radial EBUS GS (without the need for a bronchial blocker) to obtain samples safely in diagnosing PPL.

作者信息

Herath Samantha

机构信息

Department of Respiratory Medicine Northern Beaches Hospital, Macquarie University Hospital Sydney New South Wales Australia.

出版信息

Respirol Case Rep. 2023 Mar 24;11(4):e01128. doi: 10.1002/rcr2.1128. eCollection 2023 Apr.

Abstract

Cryobiopsy for peripheral pulmonary lesions suspected of lung cancer is gaining popularity due to the larger non-crushed samples capable of an array of molecular testing. However, the method of performing this procedure so far had been resource-intensive and time-consuming limiting the procedure to tertiary centres. Having to remove the cryobiopsy en masse with the bronchoscope was the main issue that hindered the safety of the procedure. We report two cases where the 1.1 mm cryoprobe was used and the cryobiopsy was extracted through the Radial EBUS GS whilst the bronchoscope remained in the bronchial tree, with excellent control of bleeding, due to the tamponading of the GS as well as the ability to attend to bleeding as soon as it occurred, due to the bronchoscope being inside the airway. This method of obtaining the cryobiopsy through the GS and keeping the bronchoscope in the airway improved the safety of cryobiopsy for PPL. Further studies are required to assess the consistency of yield and safety of this method.

摘要

由于能够进行一系列分子检测的非挤压样本更大,用于疑似肺癌的周围性肺病变的冷冻活检越来越受欢迎。然而,到目前为止,执行该操作的方法资源密集且耗时,限制了该操作仅在三级中心进行。必须用支气管镜将冷冻活检整块取出是阻碍该操作安全性的主要问题。我们报告了两例使用1.1毫米冷冻探头并通过径向EBUS GS提取冷冻活检的病例,同时支气管镜留在支气管树中,由于GS的压迫以及支气管镜在气道内能够在出血发生时立即处理出血,因此出血得到了很好的控制。这种通过GS获取冷冻活检并将支气管镜留在气道内的方法提高了PPL冷冻活检的安全性。需要进一步研究来评估该方法的取材成功率和安全性的一致性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5037/10037189/c5c60276c8f9/RCR2-11-e01128-g008.jpg

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