The Application of Transbronchial Lung Cryobiopsy and Uniportal and Tubeless Video-Assisted Thoracic Surgery in the Multidisciplinary Diagnosis of Interstitial Lung disease—A Real-World Prospective Study
The application of transbronchial lung cryobiopsy (TBLC) and uniportal and tubeless video-assisted thoracic surgery (UT-VATS) in the multidisciplinary diagnosis of interstitial lung disease (ILD) has not been demonstrated in real-world clinical practice. This prospective study included 137 patients...
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Frontiers Media S.A.
2021-06-01
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Online Access: | https://www.frontiersin.org/articles/10.3389/fmolb.2021.681669/full |
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collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Qian Han Qian Han Xiaobo Chen Xiaobo Chen Xin Xu Xin Xu Weiping Qian Weiping Qian Gui Zhao Gui Zhao Mengmeng Mao Mengmeng Mao Bingpeng Guo Bingpeng Guo Shu Xia Shu Xia Guilin Peng Guilin Peng Jianxing He Jianxing He Yingying Gu Yingying Gu Shiyue Li Shiyue Li Qun Luo Qun Luo |
spellingShingle |
Qian Han Qian Han Xiaobo Chen Xiaobo Chen Xin Xu Xin Xu Weiping Qian Weiping Qian Gui Zhao Gui Zhao Mengmeng Mao Mengmeng Mao Bingpeng Guo Bingpeng Guo Shu Xia Shu Xia Guilin Peng Guilin Peng Jianxing He Jianxing He Yingying Gu Yingying Gu Shiyue Li Shiyue Li Qun Luo Qun Luo The Application of Transbronchial Lung Cryobiopsy and Uniportal and Tubeless Video-Assisted Thoracic Surgery in the Multidisciplinary Diagnosis of Interstitial Lung disease—A Real-World Prospective Study Frontiers in Molecular Biosciences multidisciplinary diagnosis interstitial lung disease cryobiopsy uniportal and tubeless video-assisted thoracic surgery pathological diagnosis |
author_facet |
Qian Han Qian Han Xiaobo Chen Xiaobo Chen Xin Xu Xin Xu Weiping Qian Weiping Qian Gui Zhao Gui Zhao Mengmeng Mao Mengmeng Mao Bingpeng Guo Bingpeng Guo Shu Xia Shu Xia Guilin Peng Guilin Peng Jianxing He Jianxing He Yingying Gu Yingying Gu Shiyue Li Shiyue Li Qun Luo Qun Luo |
author_sort |
Qian Han |
title |
The Application of Transbronchial Lung Cryobiopsy and Uniportal and Tubeless Video-Assisted Thoracic Surgery in the Multidisciplinary Diagnosis of Interstitial Lung disease—A Real-World Prospective Study |
title_short |
The Application of Transbronchial Lung Cryobiopsy and Uniportal and Tubeless Video-Assisted Thoracic Surgery in the Multidisciplinary Diagnosis of Interstitial Lung disease—A Real-World Prospective Study |
title_full |
The Application of Transbronchial Lung Cryobiopsy and Uniportal and Tubeless Video-Assisted Thoracic Surgery in the Multidisciplinary Diagnosis of Interstitial Lung disease—A Real-World Prospective Study |
title_fullStr |
The Application of Transbronchial Lung Cryobiopsy and Uniportal and Tubeless Video-Assisted Thoracic Surgery in the Multidisciplinary Diagnosis of Interstitial Lung disease—A Real-World Prospective Study |
title_full_unstemmed |
The Application of Transbronchial Lung Cryobiopsy and Uniportal and Tubeless Video-Assisted Thoracic Surgery in the Multidisciplinary Diagnosis of Interstitial Lung disease—A Real-World Prospective Study |
title_sort |
application of transbronchial lung cryobiopsy and uniportal and tubeless video-assisted thoracic surgery in the multidisciplinary diagnosis of interstitial lung disease—a real-world prospective study |
publisher |
Frontiers Media S.A. |
series |
Frontiers in Molecular Biosciences |
issn |
2296-889X |
publishDate |
2021-06-01 |
description |
The application of transbronchial lung cryobiopsy (TBLC) and uniportal and tubeless video-assisted thoracic surgery (UT-VATS) in the multidisciplinary diagnosis of interstitial lung disease (ILD) has not been demonstrated in real-world clinical practice. This prospective study included 137 patients with no definitive diagnosis who were the subject of two multidisciplinary discussion (MDD) sessions. As indicated in the first MDD, 67 patients underwent UT-VATS and 70 underwent TBLC. The specificity of biopsy information and its contribution to final MDD diagnosis were evaluated in the second MDD. The post-operative complications and hospitalization costs associated with the two biopsy methods were compared. UT-VATS was favored for patients initially diagnosed with idiopathic pulmonary fibrosis (IPF), bronchiolitis-associated interstitial lung disease (RB-ILD)/desquamative interstitial pneumonia (DIP) and undefined idiopathic interstitial pneumonia (UIIP), while TBLC was preferred for pulmonary lymphangioleiomyomatosis (PLAM) and pulmonary alveolar proteinosis (PAP). The spirometry parameters were better in patients who underwent UT-VATS than those who underwent TBLC. UT-VATS provided more specific pathological results than TBLC (85.7 vs 73.7%, p = 0.06). In patients initially diagnosed with UIIP, pathological information from UT-VATS was more clinically useful than that obtained from TBLC, although both tests contributed similarly to cases initially diagnosed as interstitial pneumonia with auto-immune features (IPAF)/connective tissue disease-related ILD (CTD-ILD). The safety of UT-VATS was comparable with TBLC although TBLC was cheaper during hospitalization (US$4,855.7 vs US$3,590.9, p < 0.001). multidisciplinary discussion decisions about biopsies were driven by current knowledge of sampling and diagnosis capacity as well as potential risks of different biopsy methods. The current MDD considered UT-VATS more informative than TBLC in cases initially diagnosed as UIIP although they were equally valuable in patients initially diagnosed with IPAF/CTD-ILD. |
topic |
multidisciplinary diagnosis interstitial lung disease cryobiopsy uniportal and tubeless video-assisted thoracic surgery pathological diagnosis |
url |
https://www.frontiersin.org/articles/10.3389/fmolb.2021.681669/full |
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doaj-0bfe2bf6f0df477e8b3bc1c666812ae92021-06-16T04:45:12ZengFrontiers Media S.A.Frontiers in Molecular Biosciences2296-889X2021-06-01810.3389/fmolb.2021.681669681669The Application of Transbronchial Lung Cryobiopsy and Uniportal and Tubeless Video-Assisted Thoracic Surgery in the Multidisciplinary Diagnosis of Interstitial Lung disease—A Real-World Prospective StudyQian Han0Qian Han1Xiaobo Chen2Xiaobo Chen3Xin Xu4Xin Xu5Weiping Qian6Weiping Qian7Gui Zhao8Gui Zhao9Mengmeng Mao10Mengmeng Mao11Bingpeng Guo12Bingpeng Guo13Shu Xia14Shu Xia15Guilin Peng16Guilin Peng17Jianxing He18Jianxing He19Yingying Gu20Yingying Gu21Shiyue Li22Shiyue Li23Qun Luo24Qun Luo25Department of Respiratory Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, ChinaNational Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, ChinaDepartment of Respiratory Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, ChinaNational Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, ChinaNational Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, ChinaDepartment of Cardio-thoracic Surgery, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, ChinaDepartment of Respiratory Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, ChinaNational Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, ChinaDepartment of Respiratory Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, ChinaNational Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, ChinaDepartment of Respiratory Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, ChinaNational Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, ChinaDepartment of Respiratory Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, ChinaNational Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, ChinaDepartment of Respiratory Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, ChinaNational Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, ChinaNational Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, ChinaDepartment of Cardio-thoracic Surgery, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, ChinaNational Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, ChinaDepartment of Cardio-thoracic Surgery, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, ChinaNational Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, ChinaDepartment of Pathology, Guangzhou Institute of Respiratory Health, Guangzhou, ChinaDepartment of Respiratory Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, ChinaNational Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, ChinaDepartment of Respiratory Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, ChinaNational Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, ChinaThe application of transbronchial lung cryobiopsy (TBLC) and uniportal and tubeless video-assisted thoracic surgery (UT-VATS) in the multidisciplinary diagnosis of interstitial lung disease (ILD) has not been demonstrated in real-world clinical practice. This prospective study included 137 patients with no definitive diagnosis who were the subject of two multidisciplinary discussion (MDD) sessions. As indicated in the first MDD, 67 patients underwent UT-VATS and 70 underwent TBLC. The specificity of biopsy information and its contribution to final MDD diagnosis were evaluated in the second MDD. The post-operative complications and hospitalization costs associated with the two biopsy methods were compared. UT-VATS was favored for patients initially diagnosed with idiopathic pulmonary fibrosis (IPF), bronchiolitis-associated interstitial lung disease (RB-ILD)/desquamative interstitial pneumonia (DIP) and undefined idiopathic interstitial pneumonia (UIIP), while TBLC was preferred for pulmonary lymphangioleiomyomatosis (PLAM) and pulmonary alveolar proteinosis (PAP). The spirometry parameters were better in patients who underwent UT-VATS than those who underwent TBLC. UT-VATS provided more specific pathological results than TBLC (85.7 vs 73.7%, p = 0.06). In patients initially diagnosed with UIIP, pathological information from UT-VATS was more clinically useful than that obtained from TBLC, although both tests contributed similarly to cases initially diagnosed as interstitial pneumonia with auto-immune features (IPAF)/connective tissue disease-related ILD (CTD-ILD). The safety of UT-VATS was comparable with TBLC although TBLC was cheaper during hospitalization (US$4,855.7 vs US$3,590.9, p < 0.001). multidisciplinary discussion decisions about biopsies were driven by current knowledge of sampling and diagnosis capacity as well as potential risks of different biopsy methods. The current MDD considered UT-VATS more informative than TBLC in cases initially diagnosed as UIIP although they were equally valuable in patients initially diagnosed with IPAF/CTD-ILD.https://www.frontiersin.org/articles/10.3389/fmolb.2021.681669/fullmultidisciplinary diagnosisinterstitial lung diseasecryobiopsyuniportal and tubeless video-assisted thoracic surgerypathological diagnosis |