title: 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.
abstract: There is only few data available on the use of cryotechnique during medical thoracoscopy.
  
  
  
  Medical thoracoscopy was performed in consecutive patients with pleural effusion. Prospectively, biopsies were taken by rigid forceps, flexible forceps and cryoprobe. Specimen size, depth and diagnostic yield were compared.
  
  
  
  80 Patients were included. 408 biopsies were taken (205 rigid biopsies, 104 flexible biopsies, 99 cryobiopsies). Mean surface area of rigid biopsies was 22.6 ± 20.4 mm(2) (flexible biopsies: 7.1 ± 9.3 mm(2), cryobiopsies: 14.4 ± 12.8 mm(2)). Rigid biopsies were significantly larger than cryobiopsies (p < 0.001) and flexible biopsies (p < 0.001), crybiopsies were significantly larger than flexible biopsies (p < 0.01). A deep biopsy containing fatty tissue was harvested in 63 % of rigid biopsies (cryobiopsy: 49.5 % flexible biopsy: 39.5 %). In 79/80 cases (98.7 % 95 % CI cannot be calculated) a diagnosis was obtained by rigid biopsy (cryobiopsy: 73/80 cases (91.3 % 95 % CI 86.0 - 96.5 %), flexible biopsy: 74/80 cases (92.5 % 95 % CI 88.6 - 97.4 %)). Diagnostic yield achieved with cryobiopsies was inferior to the yield of rigid biopsies (Difference: 12.7 %), but non-inferior to flexible biopsies (Difference: 6.5 %).
  
  
  
  Cryobiopsies in medical thoracoscopy are safe with high diagnostic yield, non-inferior to flexible biopsies with increased tissue quantity and quality. Cryotechnique can develop an important role in medical thoracoscopy in the near future when rigid thoracoscopy is not available.
authors.affiliation: Department of Respiratory Medicine, Lungenklinik Heckeshorn, HELIOS Klinikum Emil von Behring, Berlin, Germany. henrik.wurps@helios-kliniken.de.
authors.forename: H
authors.initials: H
authors.lastname: Wurps
authors.affiliation: Department of Respiratory Medicine, Lungenklinik Heckeshorn, HELIOS Klinikum Emil von Behring, Berlin, Germany.
authors.forename: N
authors.initials: N
authors.lastname: Schönfeld
authors.affiliation: Department of Respiratory Medicine, Lungenklinik Heckeshorn, HELIOS Klinikum Emil von Behring, Berlin, Germany.
authors.forename: T T
authors.initials: TT
authors.lastname: Bauer
authors.affiliation: Department of Respiratory Medicine, Lungenklinik Heckeshorn, HELIOS Klinikum Emil von Behring, Berlin, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Bock
authors.affiliation: Department of Respiratory Medicine, Lungenklinik Heckeshorn, HELIOS Klinikum Emil von Behring, Berlin, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Duve
authors.affiliation: Department of Pneumology and Institute of Pathology, HELIOS Klinikum Emil von Behring, Berlin, Germany.
authors.forename: R
authors.initials: R
authors.lastname: Sauer
authors.affiliation: Department of Pneumology and Institute of Pathology, HELIOS Klinikum Emil von Behring, Berlin, Germany.
authors.forename: T
authors.initials: T
authors.lastname: Mairinger
authors.affiliation: Department of Pneumology and Institute of Pathology, HELIOS Klinikum Emil von Behring, Berlin, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Griff
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy / Q000379:methods*; D005260:Female; D005858:Germany; D006801:Humans; D008297:Male; D008875:Middle Aged; D010994:Pleura / Q000473:pathology*; D010996:Pleural Effusion / Q000473:pathology*; D011446:Prospective Studies; D013525:Surgical Instruments; D062606:Tertiary Care Centers; D013906:Thoracoscopy / Q000379:methods
keywords: Cryobiopsy; Flexible forceps biopsy; Medical thoracoscopy; Parietal pleura; Rigid forceps biopsy