title: A New Tool for Transbronchial Cryobiopsies in the Lung: An Experimental Feasibility ex vivo Study.
abstract: BACKGROUND
  Transbronchial cryobiopsy (TBCB) is a minimally invasive procedure to establish a diagnosis of interstitial lung disease though with the disadvantage that samples have to be extracted together with the bronchoscope.
  
  
  OBJECTIVE
  The aim of the present study was to evaluate the feasibility of a new cryoprobe with which biopsy samples can be obtained through the working channel of the flexible bronchoscope.
  
  
  METHODS
  The feasibility of obtaining transbronchial specimens with TBCB was tested and the technique was compared to transbronchial forceps biopsy (TBFB) in a prospectively randomized ex vivo animal study using a standard flexible bronchoscopy technique. The rate of successful biopsies and the duration of the sampling procedure were recorded for both methods. Size and quality of the biopsies were histologically evaluated and measured.
  
  
  RESULTS
  Biopsy samples could be obtained in 93.3% of TBCB and in 79.0% of TBFB procedures (p = 0.182). Sampling procedure time did not differ in any clinically relevant manner between the two methods. The mean specimen area of TBCB samples was significantly higher compared to that of TBFB samples (8.08 ± 5.80 vs. 2.61 ± 2.14 mm2; p < 0.0001). TBCB specimens showed less artifacts and a significantly higher percentage of alveolar tissue (53.57 vs. 25.42%; p = 0.0285) than TBFB specimens.
  
  
  CONCLUSIONS
  It is feasible to retrieve TBCB samples of good quality and size with the new mini cryoprobe through the working channel of the bronchoscope, while the bronchoscope remains within the central airways throughout the whole procedure. Further studies are necessary to evaluate the safety and efficacy in an in vivo setting.
authors.affiliation: Department of Pneumology and Critical Care Medicine, Helios Klinik Ambrock, Witten/Herdecke University, Hagen, Germany.
authors.forename: Karl-Josef
authors.initials: KJ
authors.lastname: Franke
authors.forename: Walter
authors.initials: W
authors.lastname: Linzenbold
authors.forename: Daniela
authors.initials: D
authors.lastname: Nuessle
authors.forename: Markus
authors.initials: M
authors.lastname: Enderle
authors.forename: Hans
authors.initials: H
authors.lastname: Boesmueller
authors.forename: Georg
authors.initials: G
authors.lastname: Nilius
authors.forename: Jürgen
authors.initials: J
authors.lastname: Hetzel
mesh_terms: D000818:Animals; D001706:Biopsy / Q000295:instrumentation; D001999:Bronchoscopy / Q000295:instrumentation*; D003452:Cryosurgery / Q000295:instrumentation*; D005240:Feasibility Studies; D066298:In Vitro Techniques; D008168:Lung / Q000473:pathology / Q000601:surgery*; D013552:Swine