State Key Laboratory of Respiratory Health and Multimorbidity, Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, National Center for Respiratory Medicine, National Clinical Research Center for Respiratory Diseases, Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, China-Japan Friendship Hospital, Beijing, China.
Department of Pathology, China-Japan Friendship Hospital, Beijing, China.
Respiration. 2024;103(11):701-706. doi: 10.1159/000540645. Epub 2024 Jul 30.
Endobronchial ultrasound (EBUS)-guided transbronchial mediastinal cryobiopsy (TBMC) is increasingly used to diagnose mediastinal lymphadenopathy. Various methods have been used to create a tunnel between the airway wall and the lesions for this procedure, such as electrocautery and penetration with the sheath of the needle for EBUS-transbronchial fine needle aspiration. However, those methods are complex.
We developed a new technique called EBUS-TBMC via a tunnel, and we used it in four cases of mediastinal and/or hilar lymphadenopathy. We used a puncture dilation catheter to create a tunnel between the airway wall and the target lymph node. The cryoprobe was introduced to the target lymph node and cooled with liquid carbon dioxide for 5-9 s. The probe was subsequently pulled out with the samples to complete the EBUS-TBMC via a tunnel. A definite diagnosis was made based on pathological examination of the samples obtained in all four cases. After the procedure, none of the patients experienced moderate to severe bleeding, pneumothorax, pneumomediastinum, or other adverse events.
EBUS-TBMC via a tunnel is a feasible and convenient procedure for the performance of TBMC. Further studies are required to evaluate the safety and efficacy of EBUS-TBMC via a tunnel.
经支气管超声（EBUS）引导下经支气管纵隔冷冻活检术（TBMC）越来越多地用于诊断纵隔淋巴结病变。为了进行这项操作，已经使用了各种方法在气道壁和病变之间创建一个隧道，例如电烙术和用 EBUS-经支气管细针抽吸的护套穿透。然而，这些方法比较复杂。
我们开发了一种称为经支气管超声引导下经隧道 TBMC 的新技术，并在 4 例纵隔和/或肺门淋巴结病变患者中使用。我们使用穿刺扩张导管在气道壁和目标淋巴结之间创建一个隧道。将冷冻探针引入目标淋巴结，并用液态二氧化碳冷却 5-9 秒。随后，将探针与样本一起拔出，完成经隧道的 EBUS-TBMC。根据 4 例患者获得的样本的病理检查均做出了明确诊断。操作后，无患者发生中至重度出血、气胸、纵隔气肿或其他不良事件。
经隧道 EBUS-TBMC 是一种可行且方便的 TBMC 操作方法。需要进一步的研究来评估经隧道 EBUS-TBMC 的安全性和有效性。
