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Quality of transbronchial biopsy with large forceps compared to cryobiopsy: a randomized controlled, single blinded live animal study

BACKGROUND: Transbronchial forceps biopsy is the widely accepted modality for obtaining tissue specimens for the evaluation of unexplained lung parenchymal abnormalities. However, cryoprobe biopsy provides large specimen sizes and higher yield performance. Utilization of cryoprobe biopsy remains lim...

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Autores principales: Abouzgheib, Wissam, Abramian, Osheen, Ren, Shuyue, Rafferty, William, Patel, Bhavi, Madisi, Nagendra, Kannarkatt, Paul, Lowa, Karl, Hunter, Krystal, Boujaoude, Ziad
Formato: Online Artículo Texto
Lenguaje:English
Publicado: AME Publishing Company 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9096277/
https://www.ncbi.nlm.nih.gov/pubmed/35572896
http://dx.doi.org/10.21037/jtd-21-936
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author Abouzgheib, Wissam
Abramian, Osheen
Ren, Shuyue
Rafferty, William
Patel, Bhavi
Madisi, Nagendra
Kannarkatt, Paul
Lowa, Karl
Hunter, Krystal
Boujaoude, Ziad
author_facet Abouzgheib, Wissam
Abramian, Osheen
Ren, Shuyue
Rafferty, William
Patel, Bhavi
Madisi, Nagendra
Kannarkatt, Paul
Lowa, Karl
Hunter, Krystal
Boujaoude, Ziad
author_sort Abouzgheib, Wissam
collection PubMed
description BACKGROUND: Transbronchial forceps biopsy is the widely accepted modality for obtaining tissue specimens for the evaluation of unexplained lung parenchymal abnormalities. However, cryoprobe biopsy provides large specimen sizes and higher yield performance. Utilization of cryoprobe biopsy remains limited by its need to be performed under rigid bronchoscopy and subsequent required operator expertise. We evaluated whether a larger, 2.8 mm forceps could be utilized for parenchymal biopsies. A larger size would surrogate the cryoprobe’s large sample size and forceps mechanism to obviate the need for rigid bronchoscopy and its requirement for removing the sample en bloc. METHODS: This prospective, randomized controlled, single-blinded porcine study compared a 1.9 mm cryoprobe, a 2.4 mm cryoprobe, and a 2.8 mm forceps. Assessment of histopathologic quality, sample quality and surface area, attempts to retrieve specimen samples, fluoroscopy activation time, overall procedural time, and complications were compared. RESULTS: Although cryoprobe yielded larger specimens, there was no statistical difference amongst all tools with respect to alveolar tissue surface area. There was bleeding on all cryoprobe biopsies. No bleeding was observed with forceps. Out of 32 potential combinations of interventions for bleeding control, 18 (56.3%) were made. There was no significant difference in sample quality between all three modalities. There was one pneumothorax in the forceps arm. CONCLUSIONS: Large forceps (LF) biopsy is a feasible technique while providing high diagnostic yield without the need for advanced therapeutic tools. Human studies are needed to further corroborate this technique.
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spelling pubmed-90962772022-05-13 Quality of transbronchial biopsy with large forceps compared to cryobiopsy: a randomized controlled, single blinded live animal study Abouzgheib, Wissam Abramian, Osheen Ren, Shuyue Rafferty, William Patel, Bhavi Madisi, Nagendra Kannarkatt, Paul Lowa, Karl Hunter, Krystal Boujaoude, Ziad J Thorac Dis Original Article BACKGROUND: Transbronchial forceps biopsy is the widely accepted modality for obtaining tissue specimens for the evaluation of unexplained lung parenchymal abnormalities. However, cryoprobe biopsy provides large specimen sizes and higher yield performance. Utilization of cryoprobe biopsy remains limited by its need to be performed under rigid bronchoscopy and subsequent required operator expertise. We evaluated whether a larger, 2.8 mm forceps could be utilized for parenchymal biopsies. A larger size would surrogate the cryoprobe’s large sample size and forceps mechanism to obviate the need for rigid bronchoscopy and its requirement for removing the sample en bloc. METHODS: This prospective, randomized controlled, single-blinded porcine study compared a 1.9 mm cryoprobe, a 2.4 mm cryoprobe, and a 2.8 mm forceps. Assessment of histopathologic quality, sample quality and surface area, attempts to retrieve specimen samples, fluoroscopy activation time, overall procedural time, and complications were compared. RESULTS: Although cryoprobe yielded larger specimens, there was no statistical difference amongst all tools with respect to alveolar tissue surface area. There was bleeding on all cryoprobe biopsies. No bleeding was observed with forceps. Out of 32 potential combinations of interventions for bleeding control, 18 (56.3%) were made. There was no significant difference in sample quality between all three modalities. There was one pneumothorax in the forceps arm. CONCLUSIONS: Large forceps (LF) biopsy is a feasible technique while providing high diagnostic yield without the need for advanced therapeutic tools. Human studies are needed to further corroborate this technique. AME Publishing Company 2022-04 /pmc/articles/PMC9096277/ /pubmed/35572896 http://dx.doi.org/10.21037/jtd-21-936 Text en 2022 Journal of Thoracic Disease. All rights reserved. https://creativecommons.org/licenses/by-nc-nd/4.0/Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) .
spellingShingle Original Article
Abouzgheib, Wissam
Abramian, Osheen
Ren, Shuyue
Rafferty, William
Patel, Bhavi
Madisi, Nagendra
Kannarkatt, Paul
Lowa, Karl
Hunter, Krystal
Boujaoude, Ziad
Quality of transbronchial biopsy with large forceps compared to cryobiopsy: a randomized controlled, single blinded live animal study
title Quality of transbronchial biopsy with large forceps compared to cryobiopsy: a randomized controlled, single blinded live animal study
title_full Quality of transbronchial biopsy with large forceps compared to cryobiopsy: a randomized controlled, single blinded live animal study
title_fullStr Quality of transbronchial biopsy with large forceps compared to cryobiopsy: a randomized controlled, single blinded live animal study
title_full_unstemmed Quality of transbronchial biopsy with large forceps compared to cryobiopsy: a randomized controlled, single blinded live animal study
title_short Quality of transbronchial biopsy with large forceps compared to cryobiopsy: a randomized controlled, single blinded live animal study
title_sort quality of transbronchial biopsy with large forceps compared to cryobiopsy: a randomized controlled, single blinded live animal study
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9096277/
https://www.ncbi.nlm.nih.gov/pubmed/35572896
http://dx.doi.org/10.21037/jtd-21-936
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