Safety of cryobiopsy for peripheral pulmonary lesions in older people

IF 2.4 Q2 RESPIRATORY SYSTEM

Respiratory investigation Pub Date : 2025-06-20 DOI:10.1016/j.resinv.2025.06.009

Mika Iwasaki , Keigo Uchimura , Hideaki Furuse , Tatsuya Imabayashi , Takaaki Tsuchida , Yuji Matsumoto

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Abstract

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.

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低温活检治疗老年人周围肺病变的安全性

低温活检使支气管镜医师能够进行高质量的、大范围的、全周的采样，并且据报道，当与传统的支气管镜检查相结合时，可以提高周围肺病变（ppl）的诊断率。然而，对于老年ppl患者冷冻活检的安全性知之甚少。因此，我们的目的是评估低温活检对老年ppl患者是否安全。方法我们回顾了2020年6月至2021年12月期间在国家癌症中心医院使用1.7 mm一次性冷冻探针进行ppl冷冻活检的连续患者。比较E组（老年患者，年龄≥75岁）和NE组（非老年患者，年龄≥75岁）患者的特征、术前、术中生命体征及并发症。结果共分析165例患者，其中E组45例，NE组120例。两组患者的Charlson合并症指数无显著差异。E组高血压发生率较高（55.6%比33.3%,P = 0.012），东部肿瘤合作组表现状态为1(31.1%比13.3%,P = 0.012)，抗血小板或抗凝血药物使用(22.2%比6.7%,P <；0.01)，高于NE组。并发症发生率：出血、气胸、肺炎和低氧血症无显著差异。两组生命体征变化无显著性差异。结论两组患者并发症发生率及生命体征变化无明显差异。因此，冷冻活检即使对75岁以上的患者也是安全的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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