Transbronchial Mediastinal Cryobiopsy Diagnostic Yield and Perioperative Patient Management: A Single Tertiary Center Experience
Year: 2025
Type: article
Study design: Observational Study
Abstract: OBJECTIVE: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is widely used to diagnose mediastinal lesions; however, small cytology samples from EBUS-TBNA may be inadequate in cases of benign lung diseases, hematologic disorders, and to assess the molecular profile of primary lung cancer (PLC).EBUS-guided transbronchial mediastinal cryobiopsy (TMC) obtains histological samples and potentially implies a higher diagnostic yield (DY) than EBUS-TBNA.The clinical impact of this technique and the perioperative patient management are still unclear.Our aim was to critically analyze our experience with TMC. MATERIAL AND METHODS:A single center retrospective study was conducted to evaluate TMC DY and perioperative routine over 11 months (February 2023-January 2024).RESULTS: Forty-one patients were included.The overall DY was 41.5% and 95.1% for EBUS-TBNA and TMC, respectively.TMC provided a higher DY than EBUS-TBNA in cases of hematologic disorders, benign diseases, and uncommon tumors (31% for EBUS-TBNA and 100% for TMC; 95% confidence interval (CI): 52.1-85.8,P < 0.001).For PLC, the DY and the assessment of immunohistochemical marker expression did not significantly differ between the two techniques (80% for EBUS-TBNA and 100% for TMC; 95% CI: -4.79-44.8,P = 0.13).The management of antithrombotic therapy was the same as that of EBUS-TBNA.Sedatives were administered to achieve deep sedation.After the procedure, no step-up in the level of care was observed, either in outpatients or in patients with a Charlson Comorbidity Index ≥5.CONCLUSION: TMC had a better DY than EBUS-TBNA in hematologic disorders, benign lung disease, and uncommon tumors, with an optimal tolerability profile.
Source: Thoracic research and practice
Authors: Nadia Corcione, Alfonso Pecoraro, Andrea Fidecicchi, Severo Campione, Lina Zuccatosta, Giuseppe Failla
Institution: Ospedale Antonio Cardarelli
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4409265833