Transbronchial Lung Cryobiopsy: Associated Complications
Introduction: Transbronchial lung cryobiopsy (TBC) has emerged as an alternative to surgical lung biopsy in interstitial lung disease (ILD). Besides its less invasive nature, some associated complications have been described.
Objective: To evaluate complications of TBC and associated factors.
Methods: Prospective evaluation of all patients with ILD submitted to TBC in our Center.
Results: Ninety patients were included (mean age 60±13 years; 58,9% male). Twenty-two patients presented pneumothorax [18 (81.8%) patients treated with chest tube drainage; median air leak time=1 day (IQR=2)]. Factors related to pneumothorax were as follow:
|Pneumothorax=yes (n=22; 22.4%)||Pneumothorax=no (n=68; 75.6%)||p|
|Female gender [n (%)]||13 (35.1)||24 (64.9)||0.049|
|BMI Kg/m2 [median (IQR)]||30.00 (5.42)||28.85 (7.66)||0.416|
|Presence of pleura in the histologic sample (vs. pleura absence in the histologic sample) [n (%)]||5 (31.3)||11 (68.7)||0.527|
|Biopsy >1 lobe (vs. 1 lobe biopsy) [n (%)]||3 (27.3)||8 (72.7)||1|
|Presence of pleura in the histologic sample (vs. pleura absence in the histologic sample) [n (%)]||1 (5.6)||17 (94.4)||<0.0001|
|UIP/possible UIP histology (vs. other histology types) [n (%)]||1 (5.6)||17 (94.4)||0.062|
|Fibrotic histology (vs. non-fibrotic histology) [n (%)]||3 (13.6)||19 (86.4)||0.175|
Moderate bleeding occurred in 5 patients (5.5%) and 1 patient (1.1%) presented bronchospasm and transient respiratory failure.
Conclusion: The most frequent associated complication to TBC was pneumothorax, although quickly solved. Whereas there were no statistically significant associations between pneumothorax and TBC besides presence of pleura in the histologic sample and female gender, potential candidates to TBC should be carefully selected.
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