Revista Portuguesa de Pneumologia Revista Portuguesa de Pneumologia
Rev Port Pneumol 2017;23:331-7 - Vol. 23 Num.6 DOI: 10.1016/j.rppnen.2017.07.001
Original article
Transbronchial lung cryobiopsy: Associated complications
R. Linhasa,, , R. Marçôaa, A. Oliveiraa,b, J. Almeidaa,b, S. Nevesa,b,c, S. Campainhaa,b,c
a Department of Pulmonology, Centro Hospitalar Vila Nova de Gaia/Espinho, EPE, Vila Nova de Gaia, Portugal
b Bronchoscopy Unit, Centro Hospitalar de Vila Nova de Gaia/Espinho, EPE, Vila Nova de Gaia, Portugal
c Interstitial Lung Diseases Unit, Centro Hospitalar de Vila Nova de Gaia/Espinho, EPE, Vila Nova de Gaia, Portugal
Received 02 April 2017, Accepted 09 July 2017
Abstract
Introduction

Transbronchial lung cryobiopsy (TBC) has emerged as a diagnostic alternative to surgical lung biopsy in interstitial lung disease (ILD). Despite 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 centre. Clinicodemographic variables and factors associated to TBC complications were analyzed. The effect of the variables on the complication risk was evaluated by a logistic regression model.

Results

Ninety patients were included (mean age 60±13 years; 58.9% male). Twenty-two patients presented pneumothorax, 18 (81.8%) of which were treated with chest tube drainage [median air leak time: 1 day (IQR=2)]. Grade 2 and 3 bleeding was observed in 13 (14.4%) cases. Presence of visceral pleura in the sample accounted for almost more than 10 times the odds of pneumothorax (OR=9.59, 95% CI 2.95–31.17, p<0.001). Increased body mass index (BMI) was associated with bleeding (16% additional odds for each BMI unit increase (OR=1.16, 95% CI 1.01–1.34, p=0.049).

Conclusion

The most frequent complication of TBC was pneumothorax, although rapidly reversible. There was a positive association between pneumothorax and the presence of pleura in the biopsy samples as well as between bleeding and increased BMI. More studies about TBC complications are needed to improve the selection of the candidates for this procedure.

Keywords
Transbronchial lung cryobiopsy, Interstitial lung disease, Complications
Rev Port Pneumol 2017;23:331-7 - Vol. 23 Num.6 DOI: 10.1016/j.rppnen.2017.07.001