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The safety and quality of endobronchial biopsy in children under five years old
S Saglani1, D N R Payne, A G Nicholson
1Department of Paediatric Respiratory Medicine, Royal Brompton Hospital, London SW3, UK.
Insights
Endobronchial biopsy in preschool children undergoing bronchoscopy is safe and provides adequate tissue for assessing airway inflammation and remodeling. This procedure offers valuable insights into pediatric wheezing disorders.
Area of Science:
- Pediatric pulmonology
- Respiratory pathology
Background:
- Airway pathology in pediatric wheezing disorders remains poorly understood due to challenges with invasive studies.
- Assessing the safety and quality of endobronchial biopsies in young children is crucial.
Purpose of the Study:
- To evaluate the safety and biopsy quality of endobronchial biopsies in infants and preschool children.
- To compare complication rates between children undergoing bronchoscopy with and without endobronchial biopsy.
Main Methods:
- Retrospective review of case notes for children under five who had bronchoscopy and endobronchial biopsy.
- Comparison of complication data with a matched control group undergoing bronchoscopy only.
- Histopathological assessment of biopsy quality by a consultant.
Main Results:
- 33 children underwent endobronchial biopsy, matched with 33 controls; no significant difference in complications.
- Biopsies from 30 children were assessable, identifying reticular basement membrane in all.
- Inflammation and smooth muscle presence were assessable in a majority of biopsies.
Conclusions:
- Endobronchial biopsy in preschool children under general anesthesia carries no additional risk.
- Biopsy quality is generally sufficient for evaluating airway remodeling and inflammation in pediatric wheezing disorders.
Background:
Little is known about the airway pathology of wheezing disorders in infants and preschool children, partly owing to the difficulty of undertaking invasive studies in this age group. The safety of endobronchial biopsy and the quality of biopsies obtained were reviewed in infants and preschool children.
Methods:
Case notes of children under five years of age who underwent bronchoscopy and endobronchial biopsy were reviewed. The safety of the procedure was compared in a control group matched for weight and age, undergoing bronchoscopy without endobronchial biopsy. A consultant histopathologist assessed biopsy quality.
Results:
33 patients (mean age 31 months, range 4 to 59) underwent bronchoscopy and endobronchial biopsy, and were matched with 33 controls (mean age 28 months, range 3 to 52). There was no significant difference between groups in the number, type, or severity of complications occurring during or after the procedure. Biopsies from 30 of the 33 subjects could be assessed. Reticular basement membrane was identified in all 30; inflammation could be assessed in 26; areas of smooth muscle were present in 23.
Conclusions:
In a group of preschool children undergoing bronchoscopy under general anaesthetic, performance of endobronchial biopsy carried no extra risk. The quality of biopsies obtained was usually sufficient to allow an assessment of remodelling and inflammation.
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