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Published online before print September 27, 2006
Eur Respir J 2006, doi:10.1183/09031936.00071606
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ORIGINAL ARTICLE

Hot biopsy forceps in the diagnosis of endobronchial lesions

A. Tremblay 1*, G. Michaud 2, S.J. Urbanski

1 Divisions of Respiratory Medicine, Thoracic Surgery and Medical Oncology, University of Calgary; and Southern Alberta Cancer Research Institute
2 Divisions of Respiratory Medicine, Thoracic Surgery and Medical Oncology, University of Calgary

* To whom correspondence should be addressed. E-mail: alain.tremblay{at}ucalgary.ca.


  Abstract

Electrocoagulation bronchoscopy biopsy forceps may prevent bleeding, but could also impair the quality of the specimens obtained.

Patients with endobronchial lesions during bronchoscopy underwent 6 endobronchial biopsies with a hot biopsy forceps alternating with electrocoagulation (Hot) and without (Cold). Bleeding was quantified on a scale of 1 to 4. The generator was set on "soft coagulation" mode, with power settings of 40W/60W/80W/100W for each group of 10 patients in a sequential fashion. Clinical pathology results were recorded then samples reviewed by a second blinded pulmonary pathologist.

Thirty-nine patients with 40 endobronchial lesions had 6 biopsies performed (one patient had only 4 samples taken) for a total of 238 biopsy samples. Concordance between hot and cold samples was 92.5% for clinical pathologist and 87% for blinded pathologist (p>0.05). Paired analysis suggested lower average bleeding score with the use of hot forceps (p=0.03). Overall bleeding rates for cold and hot biopsies were: grade 1- 30.3/41.2%; 2-62.2/49.6%; 3- 7.6/9.2%; 4- 0/0% (p>0.05).

The use of hot biopsy forceps for endobronchial biopsy does not appear to have a negative impact on the pathological samples. Hot biopsy forceps showed a statistically significant reduction in bleeding score unlikely to be of clinical significance.

Keywords:  Biopsy, bronchoscopy, lung cancer




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A. Tremblay
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