Abstract：
BACKGROUND: Thoracoscopy is useful for diagnosing unexplained pleural effusions. A sufficient specimen volume is often difficult to obtain using forceps biopsies (FBs) but can be obtained with pleural cryobiopsies (CBs). This study aimed to assess the utility and safety of CB during thoracoscopy in the Japanese population.
METHODS: Patients who underwent thoracoscopic CBs at the Japanese Red Cross Medical Center between January 2017 and August 2023 were included in the study. Data were retrospectively analyzed, including clinical data, thoracoscopic findings, specimen size, diagnostic yield, and complications. The number of collected specimens and the freezing time were left to the discretion of the attending physician.
RESULTS: Twenty-six patients underwent thoracoscopic CB. Specimens obtained by CB were larger than those obtained by FB. Primary lung cancer was the most common cause of pleural effusion, followed by malignant pleural mesothelioma. CB contributed to the diagnosis in 24 of 26 cases (92.3%) and FB contributed to the diagnosis in 11 of 18 cases (61.1%). Severe fibrosis could be diagnosed in all 3 cases by CB, but not by FB. The common complications of CB included bleeding at the biopsy site and atelectasis, but no severe complications occurred.
CONCLUSIONS: The utility and safety of thoracoscopic CB for diagnosing pleural effusions in Japan were verified. The diagnostic yield, specimen size, and safety profile of CB support the diagnostic utility of this method.
METHODS: Patients who underwent thoracoscopic CBs at the Japanese Red Cross Medical Center between January 2017 and August 2023 were included in the study. Data were retrospectively analyzed, including clinical data, thoracoscopic findings, specimen size, diagnostic yield, and complications. The number of collected specimens and the freezing time were left to the discretion of the attending physician.
RESULTS: Twenty-six patients underwent thoracoscopic CB. Specimens obtained by CB were larger than those obtained by FB. Primary lung cancer was the most common cause of pleural effusion, followed by malignant pleural mesothelioma. CB contributed to the diagnosis in 24 of 26 cases (92.3%) and FB contributed to the diagnosis in 11 of 18 cases (61.1%). Severe fibrosis could be diagnosed in all 3 cases by CB, but not by FB. The common complications of CB included bleeding at the biopsy site and atelectasis, but no severe complications occurred.
CONCLUSIONS: The utility and safety of thoracoscopic CB for diagnosing pleural effusions in Japan were verified. The diagnostic yield, specimen size, and safety profile of CB support the diagnostic utility of this method.
摘要：
背景：胸腔镜检查可用于诊断不明原因的胸腔积液。使用镊子活检（FBs）通常难以获得足够的标本体积，但可以通过胸膜冷冻活检（CBs）获得。这项研究旨在评估日本人群在胸腔镜检查中CB的实用性和安全性。
方法：2017年1月至2023年8月在日本红十字会医学中心接受胸腔镜CBs的患者被纳入研究。数据进行回顾性分析，包括临床数据，胸腔镜检查结果，试样尺寸,诊断产量，和并发症。收集的标本数量和冷冻时间由主治医师自行决定。
结果：26例患者接受了胸腔镜CB。CB获得的样品大于FB获得的样品。原发性肺癌是胸腔积液的最常见原因，其次是恶性胸膜间皮瘤。26例中24例（92.3%）为CB诊断，18例中11例（61.1%）为FB诊断。3例患者均可通过CB诊断为严重纤维化,但不是FB。CB的常见并发症包括活检部位出血和肺不张，但无严重并发症发生。
结论：验证了日本胸腔镜CB诊断胸腔积液的实用性和安全性。诊断结果，试样尺寸,CB的安全性和安全性支持该方法的诊断实用性。
方法：2017年1月至2023年8月在日本红十字会医学中心接受胸腔镜CBs的患者被纳入研究。数据进行回顾性分析，包括临床数据，胸腔镜检查结果，试样尺寸,诊断产量，和并发症。收集的标本数量和冷冻时间由主治医师自行决定。
结果：26例患者接受了胸腔镜CB。CB获得的样品大于FB获得的样品。原发性肺癌是胸腔积液的最常见原因，其次是恶性胸膜间皮瘤。26例中24例（92.3%）为CB诊断，18例中11例（61.1%）为FB诊断。3例患者均可通过CB诊断为严重纤维化,但不是FB。CB的常见并发症包括活检部位出血和肺不张，但无严重并发症发生。
结论：验证了日本胸腔镜CB诊断胸腔积液的实用性和安全性。诊断结果，试样尺寸,CB的安全性和安全性支持该方法的诊断实用性。
