Abstract
Objectives: Transbronchial cryobiopsy (TBCB) has been introduced as an alternative to surgical lung biopsy (SLB) in the diagnostics of interstitial lung diseases (ILD). Though, controversy on the safety of TBCB, the procedure is increasingly implemented in ILD centres as an outpatient procedure with an apparent diagnostic yield comparable to SLB. This study aimed to assess the TBCB experiences from a tertiary Danish ILD centre with respect to diagnosis and complications.
Methods: During February 2017 and November 2018 TBCB was consecutively performed in patients with unclassified ILD based on a high-resolution computed tomography. The TBCB procedure was performed in general anaesthesia according to recommended best practice using a flexible bronchoscope (Olympus) with cryoprobes (Erbe) with diameters of 1.9 or 2.4 mm.
Results: TBCB was done in 83 patients (61%/39% men/women) with mean forced vital and diffusion capacities of 88.2% and 48.6% of predicted, respectively. On basis of TBCB a confirmative diagnosis was made in 74 patients (89.2%, i.e. diagnostic accuracy) in whom idiopathic interstitial pneumonias constituted the main proportion (72.2%) of the TBCB conclusive diagnoses. The all cause 30-day mortality was 2.4%, but no procedure-related mortality or severe bleeding was registered. Minor and moderate bleeding occurred in 14.5%, pneumothorax in 12.0% with only 7.2% requiring a pleural drain, and 13.3% were admitted.
Conclusion: The diagnostic accuracy and prevalence of complications obtained by TBCB from this single centre study on unclassified ILD patients equals findings from existing literature. Our findings support TBCB as a valuable alternative to SLB to diagnose ILD in well-selected patients.
Footnotes
Cite this article as: European Respiratory Journal 2019; 54: Suppl. 63, PA3107.
This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).
- Copyright ©the authors 2019