A randomized controlled trial of electrocoagulation-enabled biopsy versus conventional biopsy in the diagnosis of endobronchial lesions.

Abstract

BACKGROUND:

Although electrocoagulation at time of endobronchial biopsy can potentially reduce procedure-related bleeding during fiberoptic bronchoscopy (FOB), it can also impair quality of tissue specimen; credible data for either are lacking.

OBJECTIVE:

To evaluate the impact of hot biopsy on the quality of tissue samples and to quantify the amount of procedure-related bleeding during endobronchial biopsy.

METHODS:

In this single-center, prospective, single-blind, randomized controlled study we included adult patients referred for FOB and having endobronchial lesions. Patients were randomized to bronchial biopsy using an electrocoagulation-enabled biopsy forceps, with (EC+ group) or without (EC- group) application of electrocoagulation current (40 W for 10 s in a monopolar mode). Procedure-related bleeding was semi-quantified by observer description, as well as through a visual analogue scale. Overall quality of biopsy specimen and tissue damage were assessed and graded by a pulmonary pathologist blinded to FOB details.

RESULT:

160 patients were randomized to endobronchial biopsy with (n = 81) or without (n = 79) the application of electrocoagulation. There were no severe bleeding episodes in either group, and severity of bleeding in the EC+ and EC- groups was similar (median visual analogue scale scores of 14 and 16, respectively). Histopathological diagnosis was similar in the EC+ and EC- groups (77.8% and 82.3%, respectively). There was no significant difference in tissue quality between the two groups.

CONCLUSION:

Use of electrocoagulation-enabled endobronchial biopsy does not alter specimen quality and does not result in any significant reduction in procedure-related bleeding.

• Authors: Ajmal Khan, Ashutosh N Aggarwal, Ritesh Agarwal, Amanjit Bal, Dheeraj Gupta
• Journal: Respiration; international review of thoracic diseases (Respiration) Vol. 81 Issue 2 Pg. 129-33 ( 2011) ISSN: 1423-0356 [Electronic] Switzerland
• PMID: 20980720 (Publication Type: Comparative Study, Journal Article, Randomized Controlled Trial)
• Copyright: Copyright © 2010 S. Karger AG, Basel.

Topics

• Adult
• Aged
• Biopsy (adverse effects, instrumentation)
• Bronchi (pathology, surgery)
• Bronchoscopy
• Electrocoagulation (adverse effects)
• Female
• Humans
• Male
• Middle Aged
• Postoperative Hemorrhage (etiology)
• Prospective Studies