L M Almeida1, B Lima2, P C Mota3, N Melo4, A Magalhães4, J M Pereira5, C S Moura6, S Guimarães6, A Morais3. 1. Pulmonology Department, Centro Hospitalar de São João, Porto, Portugal. Electronic address: leonor.fma@gmail.com. 2. Oficina de Bioestatística, Porto, Portugal. 3. Pulmonology Department, Centro Hospitalar de São João, Porto, Portugal; Faculdade de Medicina da Universidade do Porto, Porto, Portugal. 4. Pulmonology Department, Centro Hospitalar de São João, Porto, Portugal. 5. Radiology Department, Centro Hospitalar de São João, Porto, Portugal. 6. Faculdade de Medicina da Universidade do Porto, Porto, Portugal; Pathology Department, Centro Hospitalar de São João, Porto, Portugal.
Abstract
INTRODUCTION: Transbronchial lung cryobiopsy (TBLC) is increasingly used in the diagnosis of diffuse lung disease (DLD), but no data have yet been published on the learning curve associated with this technique. AIM: To evaluate diagnostic yield, lung tissue sample length and area, and procedure-related complications in a cohort of TBLC procedures to define the learning curve and threshold for proficiency. METHODS: Retrospective analysis of the first 100 TBLCs performed in different segments of the same lobe in patients with suspected DLD. We compared diagnostic yield, sample length and area, and complications between consecutive groups of patients. RESULTS: The overall diagnostic yield for TBLC was 82%. Median sample length was 5.4mm (IQR, 5-6) and median area was 19.5mm2 (IQR, 13.3-25). Pneumothorax was the most common complication (18%). On comparing the two groups of 50 consecutive patients, a significant difference was found for diagnostic yield (74% vs 90%; p=0.04), sample length (5.0mm [2.5-16] vs 6.0mm [4-12;] p<0.01) and area (17.5mm2 [6-42] vs 21.5mm2 [10-49]; p<0.01). Logarithm regression was applied to median diagnostic yield and sample length and area for groups of 10 consecutive patients to define the learning curve, which plateaued after approximately 70 procedures. CONCLUSIONS: Our findings suggest that proficiency in TBLC is achieved at approximately the 70th procedure; however they need to be validated in more series and cohorts.
INTRODUCTION: Transbronchial lung cryobiopsy (TBLC) is increasingly used in the diagnosis of diffuse lung disease (DLD), but no data have yet been published on the learning curve associated with this technique. AIM: To evaluate diagnostic yield, lung tissue sample length and area, and procedure-related complications in a cohort of TBLC procedures to define the learning curve and threshold for proficiency. METHODS: Retrospective analysis of the first 100 TBLCs performed in different segments of the same lobe in patients with suspected DLD. We compared diagnostic yield, sample length and area, and complications between consecutive groups of patients. RESULTS: The overall diagnostic yield for TBLC was 82%. Median sample length was 5.4mm (IQR, 5-6) and median area was 19.5mm2 (IQR, 13.3-25). Pneumothorax was the most common complication (18%). On comparing the two groups of 50 consecutive patients, a significant difference was found for diagnostic yield (74% vs 90%; p=0.04), sample length (5.0mm [2.5-16] vs 6.0mm [4-12;] p<0.01) and area (17.5mm2 [6-42] vs 21.5mm2 [10-49]; p<0.01). Logarithm regression was applied to median diagnostic yield and sample length and area for groups of 10 consecutive patients to define the learning curve, which plateaued after approximately 70 procedures. CONCLUSIONS: Our findings suggest that proficiency in TBLC is achieved at approximately the 70th procedure; however they need to be validated in more series and cohorts.
Authors: Jin Han Park; Ji Hoon Jang; Hyun Kuk Kim; Hang-Jea Jang; Sunggun Lee; Seong-Ho Kim; Ji Yeon Kim; Hee Eun Choi; Ji-Yeon Han; Da Som Kim; Min Kyun Kang; Eunsu Kang; Il Hwan Kim; Jae Ha Lee Journal: Tuberc Respir Dis (Seoul) Date: 2022-08-02
Authors: Manuel L Ribeiro Neto; Andrea Valeria Arrossi; Ruchi Yadav; Daniel A Culver; Sanjay Mukhopadhyay; Joseph G Parambil; Brian D Southern; Leslie Tolle; Aman Pande; Francisco A Almeida; Debasis Sahoo; Jessica Glennie; Usman Ahmad; Atul C Mehta; Thomas R Gildea Journal: BMC Pulm Med Date: 2022-06-02 Impact factor: 3.320