title: Transbronchial cryobiopsy in interstitial lung disease: experience in 106 cases - how to do it.
abstract: Transbronchial biopsy using forceps (TBB) is the first diagnostic technique performed on patients with interstitial lung disease (ILD). However, the small size of the samples and the presence of artefacts in the tissue obtained make the yield variable. Our objectives were 1) to attempt to reproduce transbronchial cryobiopsy under the same conditions with which we performed conventional TBB, that is, in the bronchoscopy unit without intubating the patient and without fluoroscopy or general anaesthesia; 2) to describe the method used for its execution; and 3) to analyse the diagnostic yield and its complications. We carried out a prospective study that included 106 patients with clinical and radiological features suggestive of ILD who underwent cryo-transbronchial lung biopsy (cryo-TBB) under moderate sedation without endotracheal intubation, general anaesthesia or use of fluoroscopy. We performed the procedure using two flexible bronchoscopes connected to two video processors, which we alternated until obtaining the number of desired samples. A definitive diagnosis was obtained in 91 patients (86%). As for complications, there were five pneumothoraces (4.7%) and in no case was there severe haemorrhage or exacerbation of the underlying interstitial disease. Cryo-TBB following our method is a minimally invasive, rapid, safe and economic technique that can be performed in a bronchoscopy suite under moderate sedation without the need for intubating the patient or using fluoroscopy and without requiring general anaesthesia.
authors.affiliation: Division of Respiratory Medicine, Hospital Universitario Central de Asturias, Oviedo, Spain.
authors.forename: Antonio
authors.initials: A
authors.lastname: Bango-Álvarez
authors.affiliation: Division of Respiratory Medicine, Hospital Universitario Central de Asturias, Oviedo, Spain.
authors.forename: Miguel
authors.identifier: 0000-0001-7183-2646
authors.initials: M
authors.lastname: Ariza-Prota
authors.affiliation: Division of Pathology, Hospital Universitario Central de Asturias, Oviedo, Spain.
authors.forename: Hector
authors.initials: H
authors.lastname: Torres-Rivas
authors.affiliation: Division of Pathology, Hospital Universitario Central de Asturias, Oviedo, Spain.
authors.forename: Luis
authors.initials: L
authors.lastname: Fernández-Fernández
authors.affiliation: Division of Radiology, Hospital Universitario Central de Asturias, Oviedo, Spain.
authors.forename: Amador
authors.initials: A
authors.lastname: Prieto
authors.affiliation: Division of Nursery, Hospital Universitario Central de Asturias, Oviedo, Spain.
authors.forename: Inmaculada
authors.initials: I
authors.lastname: Sánchez
authors.affiliation: Division of Nursery, Hospital Universitario Central de Asturias, Oviedo, Spain.
authors.forename: Maria
authors.initials: M
authors.lastname: Gil
authors.affiliation: Division of Respiratory Medicine, Hospital Valle del Nalón, Langreo, Asturias, Spain.
authors.forename: Ana
authors.initials: A
authors.lastname: Pando-Sandoval