title: Hot biopsy forceps in the diagnosis of endobronchial lesions.
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 six endobronchial biopsies each with a hot biopsy forceps, alternating between with electrocoagulation ("hot") and without ("cold"). Bleeding was quantified on a scale of 1-4, with 1 being no bleeding. The generator was set on "soft coagulation" mode, with power settings of 40, 60, 80 and 100 W for each group of 10 patients in a sequential fashion. Clinical pathology results were recorded before samples were reviewed by a second, blinded, pulmonary pathologist. A total of 39 patients with 40 endobronchial lesions had six biopsies performed (one patient had only four samples taken), giving a total of 238 biopsy samples. Concordance between hot and cold samples was 92.5% for the clinical pathologist and 87% for the blinded pathologist. Paired analysis suggested lower average bleeding score with the use of hot forceps. Overall bleeding rates for cold and hot biopsies, respectively, were as follows: grade 1: 30.3 and 41.2%; grade 2: 62.2 and 49.6%; grade 3: 7.6 and 9.2%; and grade 4: 0 and 0%. In conclusion, 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, which is unlikely to be of clinical significance.
authors.affiliation: Division of Respiratory Medicine, University of Calgary, Calgary, Canada. alain.tremblay@ucalgary.ca
authors.forename: A
authors.initials: A
authors.lastname: Tremblay
authors.forename: G
authors.initials: G
authors.lastname: Michaud
authors.forename: S J
authors.initials: SJ
authors.lastname: Urbanski
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy / Q000009:adverse effects / Q000295:instrumentation*; D016063:Blood Loss, Surgical / Q000517:prevention & control; D001984:Bronchial Neoplasms / Q000473:pathology*; D001999:Bronchoscopy; D004564:Electrocoagulation / Q000295:instrumentation*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D015203:Reproducibility of Results; D016037:Single-Blind Method