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. 2021 Mar 12;78(1):29-32.
doi: 10.31053/1853.0605.v78.n1.28798.

[Complications following transbronchial biopsy: the role of cryobiopsy in the incidence of postoperative pneumothorax]

[Article in Spanish]
David Smith  1 , Micaela Raices  2 , Maria Agustina Bequis  3 , Marcos Las Heras  4 , Esteban Wainstein  5 , Rodrigo Castro  6 , Juan Montagne  7 , Agustin Dietrich  8
Affiliations

[Complications following transbronchial biopsy: the role of cryobiopsy in the incidence of postoperative pneumothorax]

[Article in Spanish]
David Smith et al. Rev Fac Cien Med Univ Nac Cordoba. .

Abstract
in English, Spanish

Introduction: Transbronchial lung cryobiopsy (TBCB) has emerged as a diagnostic alternative to surgical lung biopsy mostly in interstitial lung disease. Despite its less invasive nature and reported higher diagnostic yield, some associated complications have been described, such as pneumothorax. Moreover, a comparison between TBCB and transbronchial forceps biopsy is seldomly made. The aim of the present study is to evaluate the incidence of pneumothorax following TBFB and TBCB and the need for pleural drainage.

Methods: Retrospective study of patients who underwent transbronchial forceps biopsy or transbronchial lung cryobiopsy, specifically those who developed postoperative pneumothorax.

Results: A total of 181 transbronchial lung biopsies were performed. Sixty three (35%) were TBFB and 118 (65%) were TBCB. Three patients in the TBFB group (5%) presented postoperative pneumothorax, while 16 patients (14%) presented pneumothorax in the TBCB group (p 0,051). The univariate analysis revealed a statistically significant association between the preoperative diagnosis of fibrosis and a higher risk of postoperative pneumothorax following TBCB (p 0.027), while other variables did not yield a statistical significance.

Conclusion: Even though more high-volume comparative studies are needed, this paper highlights the relevance of pneumothorax following TBCB. This derives in a strong need for clearly standardized procedure protocols for TBCB and careful evaluation of its complications vs. its definitive diagnostic yields.

Introducción: La criobiopsia pulmonar transbronquial (TBCB) se ha convertido en una alternativa diagnóstica a la biopsia pulmonar quirúrgica, principalmente en la enfermedad pulmonar intersticial. A pesar de su naturaleza menos invasiva y de un mayor rendimiento diagnóstico, se han descrito algunas complicaciones asociadas, como el neumotórax. En pocas oportunidades se ha comparado la TBCB y la biopsia transbronquial con fórceps (TBFB). El objetivo del presente estudio es evaluar la incidencia de neumotórax después de TBFB y TBCB y la necesidad de drenaje pleural.

Métodos: Estudio retrospectivo de pacientes que se sometieron a TBCB y TBFB, específicamente aquellos que desarrollaron neumotórax postoperatorio.

Resultados: Se realizaron un total de 181 biopsias pulmonares transbronquiales. Sesenta y tres (35%) fueron TBFB y 118 (65%) fueron TBCB. Tres pacientes en el grupo TBFB (5%) presentaron neumotórax postoperatorio, mientras que 16 pacientes (14%) presentaron neumotórax en el grupo TBCB (p 0,051). El análisis univariado reveló una asociación estadísticamente significativa entre el diagnóstico preoperatorio de fibrosis y un mayor riesgo de neumotórax postoperatorio después de TBCB (p 0.027), mientras que otras variables no arrojaron un resultado significativo.

Conclusión: Aunque se necesitan más estudios comparativos de alto volumen, este documento destaca la relevancia del neumotórax después de la TBCB. Esto deriva en una fuerte necesidad de protocolos de procedimientos claramente estandarizados para TBCB y una evaluación cuidadosa de sus complicaciones versus su rendimiento diagnóstico

Keywords: biopsy; drainage; lung; pneumothorax; forceps.

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Conflict of interest statement

Conflict of interest: None.

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