Efficacy and safety of mediastinal cryobiopsy through convex probe EBUS scope
A. Srinivasan*a (Dr), V. Pattabhiramana (Dr), S. Mahadevana (Dr), S. Annapoornia (Dr), A. Joya (Dr)
a Royal Care hospital, Coimbatore, INDIA
Purpose: To evaluate the feasibility, safety and yield of cryobiopsy of mediatinal adenopathy through convex probe EBUS scope using 1.1 mm diameter cryoprobe.
Methods: Retrospective analysis of records of patients undergoing convex probe EBUS for mediastinal adenopathy between January 2021 and May 2022 at a tertiary care referral centre. Procedures were carried out under general anaesthesia through laryngeal mask airway with convex probe EBUS scope with TBNA being performed first with 19 G Olympus needle and 1.1 mm cryoprobe being introduced thereafter through the same entry point.
Results: A total of 152 EBUS TBNA were carried out during the study period. Of these, cryo biopsy was attempted in 83 procedures (83/152; 55.14%) and was successful in obtaining tissue in 77 patients (77/83; 92.7%). There were 44 males (57.14%), 33 females (42.86%) with a mean age of 52.93 years. With TBNA, the mean number of nodes sampled per patient was 1.45 and mean passes per node was 3.59 with a diagnostic accuracy of 89.6 %. With cryo biopsy, the mean number of nodes sampled per patient was 1.09 and mean passes per node was 2.6 with a diagnostic accuracy of 90.9 %. Cryobiopsy and TBNA yielded same diagnosis in 57 patients (74.02%), increased the confidence of diagnosis when used in combination in 9 patients (11.68%; cryobiopsy in 7 and TBNA in 2), cryobiopsy alone resulted in diagnosis in 6 (7.79%) patients and TBNA alone in 6 (6.49%) patients. The combined diagnostic accuracy of TBNA and cryobiopsy was 97.4% (75/77). All patients tolerated the procedure well with no major complications and were discharged on the same day.
Conclusion: Mediastinal cryobiopsy is a safe additional procedure to convex probe guided EBUS TBNA which yields biopsy tissue in majority of the cases and has potential to complement and or improve diagnostic efficacy of EBUS TBNA cytology.
Disclosure of funding source(s): none