DIAGNOSTIC YIELD OF CRYOBIOPSY AND VIDEO-ASSISTED THORACOSCOPIC LUNG BIOPSY IN THE DIAGNOSIS OF INTERSTITIAL LUNG DISEASES

Abstract

Objective. To assess and compare the diagnostic yield of lung cryobiopsy and video-assisted thoracoscopic (VATS) lung biopsy in the diagnosis of interstitial lung diseases. Methods. A retrospective study of patients, who were examined in the Hospital of Lithuanian University of Health Sciences Kauno klinikos and underwent lung tissue cryobiopsy or VATS biopsy, was performed. Results. The study included 48 patients who underwent cryobiopsy or VATS biopsy for interstitial lung disease diagnostics. A total of 22 (45.8 %) lung tissue cryobiopsies and 26 (54.2 %) VATS biopsies were performed. There were 26 men and 22 women involved, whose mean age was 60.7 ± 10.1 years. A total of 13 (27.1 %) patients were smokers, and 8 (16.7 %) were previous smokers at the time of the biopsy procedure. The average smoking period of these patients was 29.97 ± 15.13 pack years. Exposure to potential harmful environmental factors was identified in 21 (43.8 %) patients. The most common histological pattern after cryobiopsy was usual interstitial pneumonia (UIP) (22.7 %) and non-specific interstitial pneumonia (NSIP) (22.7 %), and after VATS biopsy – UIP (30.7 %) and non-necrotizing granulomatous disease (19.2 %). There was no significant difference between the diagnostic yield of cryobiopsy (77.3 %) and VTS biopsy (88.5 %) (p>0.05). 4.5 % of patients developed procedure-related pneumothorax, and the same percentage of patients had bleeding after cryobiopsy. The rate of infectious complications was higher after VATS biopsy than cryobiopsy (0 % vs. 11.5 %). Conclusions. Cryobiopsy diagnostic yield is as high as the gold diagnostic standard – VATS biopsy. Considering the safety of these two procedures, there was no significant difference between complication rates of cryobiopsy and VATS biopsy.