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Canadian Respiratory Journal
Volume 2018, Article ID 6746470, 8 pages
Research Article

Feasibility and Safety of Pleuroscopic Cryobiopsy of the Pleura: A Prospective Study

1Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
2Department of Respiratory Therapy, China Medical University, Taichung, Taiwan
3Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan
4School of Medicine, China Medical University, Taichung, Taiwan
5Department of Internal Medicine, Hyperbaric Oxygen Therapy Center, China Medical University, Taichung, Taiwan
6Department of Life Science, National Chung Hsing University, Taichung, Taiwan

Correspondence should be addressed to Chih-Yen Tu; moc.liamg@uttsehc

Received 10 August 2017; Revised 8 October 2017; Accepted 21 December 2017; Published 22 January 2018

Academic Editor: Fu-Tsai Chung

Copyright © 2018 Chia-Hung Chen et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Background. The aim of this study was thus to evaluate the feasibility and safety of taking biopsy specimens by cryoprobe from the parietal pleura during semirigid pleuroscope. Methods. In a single-center, observational, prospective study, patients with exudative pleural effusion (EPE) were evaluated with a semirigid pleuroscope between January 2015 and July 2017. Each patient underwent pleural biopsy using flexible forceps and flexible cryoprobe through pleuroscope following diagnostic thoracentesis and closed pleural biopsy (CPB). Results. A total of 92 patients (median age 64 years) were included in the study, most of whom were men (65.2%). Cytological cell block (CCB) and CPB made definitive diagnoses in 32/92 (34.8%) and 25/92 (27.5%), respectively; flexible forceps biopsy (FFB) and cryoprobe biopsy (CB) established definitive diagnoses in 84/92 (91.3%) and 91/92 (98.9%), respectively. The sample obtained by CB (9.4 ± 4.9 mm) was significantly larger than the other two methods: FFB (4.2 ± 2.3 mm) or CPB (1.9 ± 1.0 mm) (). The immunohistochemical (IHC) staining was more easily performed with CB (98.9%) compared to either FFB (87.0%) or CPB (13.0%). There were no significant complications or procedure-related deaths. Conclusions. Based on these results, CB during semirigid pleuroscope has a high diagnostic yield, differentiating EPE of unknown etiology with satisfactory effectiveness and safety.