Comparison of Conventional and Hot Biopsy Forceps in the Diagnosis of Endobronchial Lesions

比較傳統及電燒式切片夾於氣管內病灶之診斷

郭惟格(Wei-Ke Kuo) ； 花仲涇(Chung-Ching Hua) ； 劉育志(Yu-Chih Liu) ； 林群堯(Chun-Yao Lin) ； 黃志宇(Chih-Yu Huang) ； 于鍾傑(Chung-Chieh Yu) ； 陳宏杰(Hung-Jie Chen) ； 吳黃平(Huang-Pin Wu) ； 游騰仁(Teng-Jen Yu) ； 朱建民(Chien-Min Chu)

《胸腔醫學》 31卷3期 (2016/06) Pp. 135-141

摘要

前言：電燒式切片夾（hot biopsy forceps）是被設計來減少氣管內切片相關之出血。目前為止，對於電燒式切片夾對於氣管內病灶之診斷及相關出血的效用仍未非常清楚。本篇文章分析傳統及電燒式切片夾於可獲得切片樣本數，切片過程暫停數及組織病理診斷率之不同。方法：本篇文章回朔性的從2006 年1 月到2012 年2 月期間，針對本教學醫院接受氣管內病灶切片的案例作病歷資料回顧。一共收集了232 個病例，其中116 個接受傳統切片夾切片，另外116 個接受電燒式切片夾切片。結果：取得切片樣本數和惡性腫瘤診斷率在電燒式切片這組皆較高（biopsy specimen: 3.86 vs. 3.46, p=0.036 malignancy diagnosis rate: 63.8% vs. 47.4%, p=0.0012）。此外，電燒式切片夾這組的非特異性病理診斷率（non-specific pathological diagnosis rate）較低（34.5% vs. 49.1%, p=0.0024）。兩組在切片過程暫停數並無差異（hot vs. conventional: 1 vs 3, p=0.622）。結論：使用電燒式切片夾進行氣管內病灶之切片取樣可以得到更多的樣本以及達到更高的惡性腫瘤診斷率。

關鍵字

支氣管鏡 ； 電燒術 ； 電燒凝固術 ； 氣管內切片 ； 熱能夾切片

並列摘要

Background and objectives: Use of electrocoagulation (hot biopsy forceps) when performing endobronchial biopsy is designed to reduce procedure-related bleeding. At this time, evidence regarding the effective application of hot biopsy in the diagnosis of endobronchial lesions and the bleeding rate is unclear. This study analyzed the number of specimens obtained, number of terminated procedures and histopathological diagnosis between conventional biopsy and hot biopsy groups. Methods: This retrospective chart review study was conducted from January 2006 to February 2012 in a single teaching hospital. The medical records of 232 patients that underwent endobronchial biopsy were reviewed: 116 underwent endobronchial biopsy with conventional biopsy forceps and 116 with hot biopsy forceps. Results: The number of biopsy specimens and the malignancy diagnosis rate were significantly higher in the hot biopsy forceps group (biopsy specimens: 3.86 vs. 3.46, p=0.036; malignancy diagnosis rate: 63.8% vs. 47.4%, p=0.0012), and the non-specific pathological diagnosis rate was significantly lower (34.5% vs. 49.1%, p=0.0024). The 2 groups did not differ with regard to the number of terminated procedures (hot vs. conventional: 1 vs 3, p=0.622). Conclusions: More specimens can be obtained during endobronchial biopsy with hot biopsy forceps, and can result in a higher malignancy diagnosis rate.

並列關鍵字

bronchoscopy ； electrocautery ； electrocoagulation ； endobronchial biopsy ； hot biopsy forceps