Skip to main content

Advertisement

SpringerLink
Log in

Safety and Feasibility of Pleural Cryobiopsy Compared to Forceps Biopsy During Semi-rigid Pleuroscopy

  • Pleural Disease
  • Published:
Lung Aims and scope Submit manuscript

Abstract

Background

Pleural biopsy is often obtained in patients with undiagnosed exudative pleural effusion during pleuroscopy. Standard forceps have been traditionally used for the biopsy. Cryoprobes are being increasingly used for transbronchial lung biopsy as they obtain larger specimens and have less crush artifact. However, the safety and feasibility of cryoprobe biopsy compared to standard forceps for pleural biopsy has not been fully assessed.

Objectives

The objective of this study was to demonstrate the safety and feasibility of cryoprobe biopsy in the pleural space using semi-rigid pleuroscopy.

Methods

Patients with idiopathic exudative pleural effusions underwent pleuroscopy. The procedure was done in the endoscopy suite with full barrier precautions and moderate sedation. Pleural biopsies were initially taken with a 2.0-mm saw-toothed forceps followed by a 2.4-mm cryoprobe (ERBECRYO, ERBE, US). The freeze time for each biopsy was 3 s.

Results

There were a total of ten patients, five males and five females. The mean age was 69 years (SD ± 11 years). The mean number of biopsies taken from the parietal pleura using forceps was 4.5 (SD ± 1.5) vs. 3.7 (SD ± 1.4) using cryoprobe. The mean cumulative tissue volume with forceps biopsy was 80 cu. mm; the mean cumulative tissue volume with cryobiopsy was 320 cu. mm, p = 0.007. The diagnostic yields were similar in both the groups. There was no increased incidence of bleeding, chest wall injury, or pain using cryoprobe in any of the patients.

Conclusion

The use of cryoprobe for parietal pleural biopsy via semi-rigid pleuroscopy was feasible and safe in this small pilot study.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Ernst A et al (2002) A novel instrument for the evaluation of the pleural space: an experience in 34 patients. Chest 122(5):1530–1534

    Article  PubMed  Google Scholar 

  2. Lee P, Colt HG (2005) Rigid and semirigid pleuroscopy: the future is bright. Respirology 10(4):418–425

    Article  PubMed  Google Scholar 

  3. Lee P et al (2007) Prospective evaluation of flex-rigid pleuroscopy for indeterminate pleural effusion: accuracy, safety and outcome. Respirology 12(6):881–886

    Article  PubMed  Google Scholar 

  4. McLean AN et al (1998) Investigation of pleural effusion: an evaluation of the new Olympus LTF semiflexible thoracofiberscope and comparison with Abram’s needle biopsy. Chest 114(1):150–153

    Article  CAS  PubMed  Google Scholar 

  5. Lentz RJ et al (2016) Transbronchial cryobiopsy can diagnose constrictive bronchiolitis in veterans of recent conflicts in the middle east. Am J Respir Crit Care Med 193(7):806–808

    Article  PubMed  PubMed Central  Google Scholar 

  6. Poletti V (2016) Increasing diagnostic value of transbronchial lung cryobiopsy. Respiration 91(4):350

    Article  PubMed  Google Scholar 

  7. Poletti V, Ravaglia C, Tomassetti S (2016) Transbronchial cryobiopsy in diffuse parenchymal lung diseases. Curr Opin Pulm Med 22(3):289–296

    Article  PubMed  Google Scholar 

  8. Ramaswamy A et al (2016) Comparison of transbronchial and cryobiopsies in evaluation of diffuse parenchymal lung disease. J Bronchology Interv Pulmonol 23(1):14–21

    Article  PubMed  PubMed Central  Google Scholar 

  9. Rozman A et al (2014) Feasibility and safety of parietal pleural cryobiopsy during semi-rigid thoracoscopy. Clin Respir J 10:574–578

    Article  Google Scholar 

  10. Thomas R et al (2015) Pleuroscopic cryoprobe biopsies of the pleura: a feasibility and safety study. Respirology 20(2):327–332

    Article  PubMed  Google Scholar 

  11. Maturu VN et al (2015) Pleuroscopic cryobiopsy: case series and systematic review. J Bronchol Interv Pulmonol 22(3):e11–e13

    Article  Google Scholar 

  12. Wurps H et al (2016) Intra-patient comparison of parietal pleural biopsies by rigid forceps, flexible forceps and cryoprobe obtained during medical thoracoscopy: a prospective series of 80 cases with pleural effusion. BMC Pulm Med 16(1):98

    Article  CAS  PubMed  PubMed Central  Google Scholar 

Download references

Author Contributions

VP Patient enrollment, data collection, data analysis, manuscript preparation. RWS Data analysis, manuscript preparation. EH IRB preparation. RM primary investigator, manuscript preparation.

Author information

Authors and Affiliations

  1. Division of Pulmonary & Critical Care Medicine, WakeMed Health and Hospitals, 3024 New Bern Avenue, Suite G03, Raleigh, NC, 27610, USA

    Vikas Pathak

  2. Division of Pulmonary and Critical Care Medicine, Virginia Commonwealth University Health System, Richmond, VA, USA

    Ray W. Shepherd & Rajiv Malhotra

  3. Division of Pulmonary and Critical Care Medicine, Kettering Medical Center, Dayton, OH, USA

    Ehab Hussein

Authors
  1. Vikas Pathak
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ray W. Shepherd
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Ehab Hussein
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Rajiv Malhotra
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Vikas Pathak.

Ethics declarations

Conflict of interest

The authors report no real or potential conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Pathak, V., Shepherd, R.W., Hussein, E. et al. Safety and Feasibility of Pleural Cryobiopsy Compared to Forceps Biopsy During Semi-rigid Pleuroscopy. Lung 195, 371–375 (2017). https://doi.org/10.1007/s00408-017-9998-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00408-017-9998-0

Keywords

Search

Navigation