title: Safety of Cryo-Transbronchial Biopsy in Diffuse Lung Diseases: Analysis of Three Hundred Cases.
abstract: BACKGROUND
  Transbronchial biopsy (TBB) which is performed with metal forceps (forceps TBB) has been accepted as a useful technique in establishing diagnoses of diffuse lung diseases (DLDs). The use of cryoprobes to obtain alveolar tissue (cryo-TBB) is a new method which is currently used by our institute as well as others with excellent results.
  
  
  OBJECTIVE
  To assess the safety of cryo-TBB compared with conventional forceps TBB.
  
  
  METHODS
  We performed a retrospective data evaluation of 300 consecutive patients who underwent cryo-TBB between January 2012 and April 2014 and compared them with historical cases treated with forceps TBB between 2010 and 2012. The results of both diagnostic modalities were compared based on pathological reports. The major complications (significant bleeding and pneumothorax) were compared, along with postprocedural hospitalization.
  
  
  RESULTS
  Pneumothorax was observed in 15 cases (4.95%) treated with cryo-TBB versus 9 cases (3.15%) treated with forceps TBB, with no significant difference (p = 0.303). The insertion of a chest tube was necessary in 6 (2%) and 4 (1.3%) of the cases having undergone cryo-TBB or forceps TBB, respectively (p = 0.8). In the cryo-TBB group, bleeding was encountered in 16 cases (5.2%), and it occurred in 13 cases (4.5%) of the forceps TBB group, with no significant difference in rates (p = 0.706). Also, there was no significant difference in hospital admission rates between the groups [cryo-TBB: 10 (3.3%); forceps TBB: 4 (1.44%); p = 0.181]. The safety profile of cryo- and forceps TBB remained the same even when stratified according to indications for TBB, i.e. immunocompromised hosts, patients after lung transplantation and those with DLDs.
  
  
  CONCLUSIONS
  In patients with DLDs, cryo-TBB is as safe as forceps TBB.
authors.affiliation: Pulmonary Institute, Rabin Medical Center, Petah Tikva, Israel.
authors.forename: Evgeni
authors.initials: E
authors.lastname: Gershman
authors.forename: Oren
authors.initials: O
authors.lastname: Fruchter
authors.forename: Fox
authors.initials: F
authors.lastname: Benjamin
authors.forename: Abed Rahman
authors.initials: AR
authors.lastname: Nader
authors.forename: Dror
authors.initials: D
authors.lastname: Rosengarten
authors.forename: Victoria
authors.initials: V
authors.lastname: Rusanov
authors.forename: Ludmila
authors.initials: L
authors.lastname: Fridel
authors.forename: Mordechai R
authors.initials: MR
authors.lastname: Kramer
mesh_terms: D001706:Biopsy / Q000379:methods*; D001999:Bronchoscopy / Q000379:methods*; D015331:Cohort Studies; D003452:Cryosurgery / Q000379:methods*; D005260:Female; D006801:Humans; D016867:Immunocompromised Host / Q000276:immunology; D008168:Lung / Q000473:pathology*; D008171:Lung Diseases / Q000175:diagnosis / Q000473:pathology; D016040:Lung Transplantation; D008297:Male; D008875:Middle Aged; D011014:Pneumonia / Q000175:diagnosis / Q000276:immunology / Q000473:pathology*; D011030:Pneumothorax / Q000453:epidemiology; D011183:Postoperative Complications / Q000453:epidemiology; D019106:Postoperative Hemorrhage / Q000453:epidemiology; D012189:Retrospective Studies; D013525:Surgical Instruments