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- 저자 : ( Tomohisa Baba ) (검색결과 1 건)
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Transbronchial Lung Cryobiopsy : single institutional report in Japan
( Takashi Niwa ),( Tomohisa Baba ),( Tamiko Takemura ),( Kenta Murotani ),( Takashi Ogura ) 대한결핵 및 호흡기학회 2019 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.127 No.-
Background: In out institution Transbronchial lung cryobiopsy (TBLC) was introduced at May, 2017. Now we experienced TBLC for 500 and more patients. We summarize here our experience.Method: All patients who performed TBLC from May 2017 to December 2018 at Kanagawa cardiovascular and respiratory center were enrolled in this study. We assessed safety profiles and diagnostic yield for all patients and calculated CUSUM score to analyze the learning curve of TBLC for patients in first half year. For the patients with peripheral lesion TBLC was performed under fluoroscopy with Fogarty® occlusion catheter to manage pneumothorax and bleeding. Results: Of 512 cases, diffuse parenchymal lung disease was 492 and lung cancer was 20 cases. Incidence of pneumothorax was 3.9% (20 cases) and there were no patient of pneumothorax to need surgical operation. All bleeding was managed by occlusion catheter. Acute exacerbation was observed in one case. During a half year in 174 cases incidence of pneumothorax changed at 79th experience and bleeding incidence changed at 69th experience. For patients with peripheral small lesion we use extra-large size (2.7mm) guide sheath (Machida® SG-27092) to do Endobronchial ultrasound guided cryobiopsy (EBUS-Cryo). EBUS-Cryo with extra-large GS were performed for 13 patients. Median target size in computed tomography was 25mm (12-43mm) and diagnostic yield was 84.6%. In case with positive echo result by radial echo (within or adjacent to) diagnostic yield was 100% and invisible cases could not diagnose. Discussion: In our study incidence of TBLC was low compared to previous report. This results revealed fluoroscopy guided TBLC with balloon occlusion method is well tolerable. And Extra-large size GS enable us EBUS-Cryo conveniently even if using 1.9 mm cryoprobe. Using larger probe in EBUS-Cryo seems to be better diagnostic yield and 2.7mm GS is promising. Conclusion: TBLC and EBUS-Cryo using extra-large size GS is useful. Further investigation is warranted.
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