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Safety of cryobiopsy for peripheral pulmonary lesions in older people
Mika Iwasaki1, Keigo Uchimura2, Hideaki Furuse3
1Department of Endoscopy, Respiratory Endoscopy Division, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, Japan; Department of Respiratory Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, Japan.
Background:
Cryobiopsy enables bronchoscopists to perform high-quality, large, and entirely circumferential sampling and has been reported to improve the diagnostic yield of peripheral pulmonary lesions (PPLs) when combined with conventional bronchoscopic procedures. However, little is known regarding the safety of cryobiopsy for PPLs in older patients. Thus, we aimed to evaluate whether cryobiopsy is safe when performed on elderly patients with PPLs.
Methods:
We reviewed consecutive patients who underwent cryobiopsy for PPLs using a 1.7-mm single-use cryoprobe at the National Cancer Center Hospital between June 2020 and December 2021. Patients' characteristics, vital signs before and during the procedures, and complications were compared between the E (elderly patients, aged ≥75 years) and NE (non-elderly patients, aged <75 years) groups.
Results:
A total of 165 patients were analyzed, with 45 in the E group and 120 in the NE group. No significant difference was observed in the Charlson Comorbidity Index between the two groups. The E group had higher rates of hypertension (55.6 % vs. 33.3 %, P = 0.012), eastern cooperative oncology group-performance status of 1 (31.1 % vs. 13.3 %, P = 0.012), and antiplatelet or anticoagulant use (22.2 % vs. 6.7 %, P < 0.01) than the NE group. There were no significant differences in the complication rates: bleeding, pneumothorax, pneumonia, and hypoxemia. Additionally, no significant difference was observed in vital sign changes during the procedures.
Conclusions:
There were no significant differences in complication rates or changes in vital signs between the two groups. Therefore, cryobiopsy may be safe even for patients over 75 years of age.
