0
Correspondence |

Developments in Cryobiopsy for Interstitial Lung Disease May Be Cost Saving FREE TO VIEW

Charles Sharp, BMBCh; Huzaifa Adamali, MD; Andrew Medford, MD, FCCP
Author and Funding Information

FINANCIAL/NONFINANCIAL DISCLOSURES: None declared.

aAcademic Respiratory Unit, North Bristol NHS Trust, Bristol, South Gloucestershire

bBristol ILD Service, North Bristol NHS Trust, Bristol, South Gloucestershire

cNorth Bristol Lung Centre, North Bristol NHS Trust, Bristol, South Gloucestershire

dAcademic Respiratory Unit, University of Bristol, Bristol, South Gloucestershire

CORRESPONDENCE TO: Charles Sharp, BMBCh, Academic Respiratory Unit, University of Bristol, Learning and Research Bldg, Southmead Hospital, Bristol, BS10 5NB, UK


Copyright 2016, American College of Chest Physicians. All Rights Reserved.


Chest. 2017;151(2):512-513. doi:10.1016/j.chest.2016.10.060
Text Size: A A A
Published online

There has been increasing interest in transbronchial cryobiopsy for diagnosis in interstitial lung disease. As we highlighted in our systematic review and cost analysis, this has the potential to be cost saving in the setting of a payment by results system. Recently, it has been demonstrated in a porcine model that a new sheath cryoprobe gives equivalent biopsy quality without the need for en bloc bronchoscope removal or an endotracheal tube. This has the potential to shorten procedure times by 34.8% and reduce bleeding by 81.8% and the incidence of pneumothorax by 66.7%.

With the shorter procedure time and no requirement for anesthetic airway support, this would augment the potential cost savings over surgical lung biopsy from our analysis from £210 to £934 per patient in the first year and from £647 to £1372 per patient in subsequent years. This could be a compelling argument when combined with the significant reduction in morbidity related to the procedure.

This development in cryobiopsy technology has the potential to significantly increase the scope of flexible bronchoscopy for diagnosis not only of interstitial lung disease but also of pulmonary nodules if used as an adjunct to guided techniques, as highlighted in the accompanying editorial. There is an urgent need for appropriately designed and conducted randomized controlled studies of cryobiopsy to establish its place in the armamentarium of interventional bronchoscopy.

References

Sharp C, McCabe M, Adamali H, Medford AR. Use of transbronchial cryobiopsy in the diagnosis of interstitial lung disease-a systematic review and cost analysis [published online ahead of print August 13, 2016].QJM.http://dx.doi.org/10.1093/qjmed/hcw142.
 
Yarmus L.B. .Semaan R.W. .Arias S.A. .et al A randomized controlled trial of a novel sheath cryoprobe for bronchoscopic lung biopsy in a porcine model. Chest. 2016;150:329-336 [PubMed]journal. [CrossRef] [PubMed]
 
Pastis N.J. .Silvestri G.A. . Could cryo-biopsies lead bronchoscopy into the Ice Age? Chest. 2016;150:270-272 [PubMed]journal. [CrossRef] [PubMed]
 

Figures

Tables

References

Sharp C, McCabe M, Adamali H, Medford AR. Use of transbronchial cryobiopsy in the diagnosis of interstitial lung disease-a systematic review and cost analysis [published online ahead of print August 13, 2016].QJM.http://dx.doi.org/10.1093/qjmed/hcw142.
 
Yarmus L.B. .Semaan R.W. .Arias S.A. .et al A randomized controlled trial of a novel sheath cryoprobe for bronchoscopic lung biopsy in a porcine model. Chest. 2016;150:329-336 [PubMed]journal. [CrossRef] [PubMed]
 
Pastis N.J. .Silvestri G.A. . Could cryo-biopsies lead bronchoscopy into the Ice Age? Chest. 2016;150:270-272 [PubMed]journal. [CrossRef] [PubMed]
 
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Related Content

Customize your page view by dragging & repositioning the boxes below.

Find Similar Articles
  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543