Transbronchial Lung Cryobiopsy in children

ABSTRACT

Background

Transbronchial Lung Cryobiopsy (TBLC) is a novel technique, available globally only in a limited number of centers. Since the data on the role of TBLCs amongst pediatric patients is limited, the aim was to evaluate its efficacy in diagnosing lung diseases amongst children.

Methods

The records of 28 pediatric patients were retrospectively reviewed from October 2016 till September 2018. The participants’ demographic information, procedural indications, sample adequacy, diagnostic utility, and the complications associated with this type of bronchoscopy apparatus were further assessed.

Results

Twenty-eight pediatric patients aged 22 months to 17 years underwent TBLC. From the 73 obtained biopsies, 97% had an adequate sampling size. The diagnostic yield of this method was 92.8%. The most common complication was mild bleeding. Transient hypoxemia and bronchospasm were observed in eleven and eight patients, respectively. Furthermore, most of them (78.6%) had uneventful post-procedure and recovery.

Conclusions

TBLC was a relatively safe and effective method with high accuracy and fewer complications in diagnosing and monitoring lung diseases in the selected children. However, more extensive multicentre trials are warranted to corroborate the potential benefits of this novel technique.

KEYWORDS:

• Children
• bronchoscopy
• transbronchial
• lung biopsy
• cryoprobe
• cryobiopsy
• interstitial lung disease

Article highlights

• CLD and chILD are two challenging problems in children with chronic respiratory disorders, resulting from a wide spectrum of clinical causes that requires proper diagnosis.

• The gold standard diagnostic test for CLD and chILD is to obtain a lung tissue biopsy.

• TBLC can be a novel method for taking an appropriate lung tissue biopsy.

• TBLC is a safe method in pediatric if performed in a well-equipped hospital with expert pediatric interventional bronchoscopists.

• The most common TBLC complication is grade one bleeding that can easily manage by the appropriate maneuvers and methods.

Ethical approval

Ethics approval has been waived from the Ethical Committee because this study is a description of case series and with retrospective nature.

Informed consents

Informed consents for publication have been obtained from parents of all patients.

Conflicts of interest

The author declare that they have no conflict of interest.

Notes on contributions

MAM designed the study, wrote, performed the literature search and the statistics and drafted the first manuscript, revised and finally approved the manuscript. MAM contributed to all parts of this work. Moreover, MAM contributed to the statistical analysis and writing of the manuscript draft. MAM designed the study and had full access to all data in the study, and takes full responsibility for the integrity of the data. Besides, MAM contributed to data acquisition and data interpretation and provided critical revision of the manuscript. Overall, MAM contributed to data acquisition and reviewed and approved the final version.

Ethics statement

This study was compliant with Ethical Standards. Ethical approval and parental/caregiver informed consent were obtained accordingly.

Additional information

Funding

This paper was not funded.