The diagnostic value of clamp lung biopsy and lung cryobiopsy guided by radial ultrasound in peripheral pulmonary lesions

Objective To explore the diagnostic value and safety of clamp lung biopsy guided by intrabronchial ultrasound under fiberbronchoscope compared with frozen lung biopsy in peripheral pulmonary lesions. Methods A retrospective study was conducted on 55 patients, who received lung biopsy under the guidance of radial endobronchial ultrasound in the First Affiliated Hospital of Bengbu Medical College from December 2018 to December 2019 and were finally diagnosed. Patients were divided into transbronchial lung biopsy (TBLB) group(n=29) and transbronchial lung cryobiopsy (TBLC) group(n=26). The diagnostic rate and complications of peripheral pulmonary lesions were compared between the two groups. Results The diagnostic rates of TBLC group (80.8%, 21/26) were significantly higher than that of TBLB group (55.2%, 16/29), χ²=4.080, P=0.043. In this study, the majority of peripheral pulmonary lesions were malignant, accounting for 56.4%, among which adenocarcinoma was the most common. Among benign diseases, tuberculosis was the most common, accounting for 62.5%. Complications in the two groups:2 cases in both TBLC group and TBLC group suffered from hemorrhage, all of which were small amount of bleeding, which could be alleviated after bronchus hemostasis treatment with injection of ice saline, epinephrine or thrombin at the biopsy site. The incidence of pneumothorax in TBLB group (6 cases) was higher than that in TBLC group (2 cases), and 2 patients needed closed chest drainage, but there was no significant difference between the two groups (χ²=0.964, 0.165, all P>0.05). There were no deaths in both group. Conclusion Radial endobronchial ultrasound combined with lung cryobiopsy has a high diagnostic rate and safety for peripheral pulmonary lesions.