Author of

• 11856

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  P2.17 - Poster Session 2 - Bronchoscopy, Endoscopy (ID 183)

  • Event: WCLC 2013
  • Type: Poster Session
  • Track: Pulmonology + Endoscopy/Pulmonary
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/29/2013, 09:30 - 16:30, Exhibit Hall, Ground Level

  • 11858

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    P2.17-002 - Retrospective study of 5-year experience with endobronchial cryobiopsy in Republic of Estonia. (ID 1055)

    09:30 - 09:30  |  Author(s): T. Vanakesa
    • Abstract

    Background
    We report North Estonia Medical Center and Tartu University Clinic 5-year experience with cryobiopsy in diagnosing endobronchial malignancies. The purpose of this study is to assess the diagnostic efficacy of the procedure, sampled tissue size and side effects of cryobiopsy in patients with central airways malignances.

    Methods
    The freezing system which operates according to the principle of the Joule-Thomson effect was used for cryobiopsy (CB) during fiberoptic videobronchoscopy (FVB) under local anaestesia (Erbokryo CA, ERBE Elektromedizin GmbH, Germany) with use of 2.4 mm cryoprobe.

    Results
    Three hundred and thirteen patients (mean age 65.5 yr, range 17- 88) with clinical and radiological suspicion of endobronchial malignancy underwent FVB with routine collection of CB samples from February 2007 to January 2013. A total of 385 cryobiopsies, ranging from 1 to 4 for a patient, with median sample size of 9.86 mm, were obtained from the trachea, main bronchi or lobar bronchi. The CB specimens were free of artefacts, contained sufficient tissue for the definite pathological diagnosis and had well-preserved surface epithelium, if visible in the biopsy, according to the pathology reports. The diagnosis of endobronchial malignancy was verified in 298 patients (95,5.%) with CB-s. In 3 cases, all CB-s taken from segmental and subsegmental airways, re-bronchoscopy with new CBs was successfully applied to verify the cancer diagnosis. In 15 cases (4, 79 %), the use of CB was unable to confirm the malignancy: the morphology was confirmed by using other minimally invasive endoscopic methods (TBNA, EBUS-TBNA or EUS-FNA). No CB associated complications requesting special intervention were observed. In 35 cases, immediate re-canalization of the bronchi obstructed by the endobronchial tumor was achieved in parallel to CBs for the diagnosis. No difference in diagnostic results was observed regardless the number of collected tissue samples for a patient.

    Conclusion
    CB is superior human bronchial tissue biopsying method; biopsying efficiency is very high, sampled tissue size and morphological quality cryo-bioptates is excellent, and no procedure related complications were observed. CB during FVB has also paramount value in terms of preserving high quality tissue for the genetic mutations testing in the era of rapidly evolving personalized medicine in lung cancer.