Cryobiopsy guided by electromagnetic navigation bronchoscopy for the diagnosis of peripheral lung nodules.

Electromagnetic naviogation bronchoscopy (ENB) allows guiding different techniques to obtain lung samples. The use of cryoprobes through the ENB's channel could mean an improvement in diagnosis avoiding the performance of additional procedures. <bold>Objective:</bold> Analyze the diagnostic yield obtained using ENB with fine-needle aspiration (FNA), forceps biopsy and cryobiopsy and the safety of the procedure. Material and methods: Retrospective observational study of patients with undiagnosed peripheral lung nodules. The procedure was carried out with orotracheal intubation and general anesthesia. Samples were obtained using ENB with FNA, forceps and /or criobiopsy at the discretion of the endoscopist and according to the type of lung lesion (fig 1). Rapid On Site Evaluation was available in all cases. The clinical-demographic characteristics of the patients and nodules were evaluated, as well as variables of diagnostic performance and safety (fig 2). <bold>Results:</bold> Forty-six nodules from 46 patients were studied. Sample collection was performed using FNA (95.7%), forceps biopsy (67.4%) and cryoprobe (54.3%). A higher diagnostic confirmation was obtained in procedures that include cryobiopsies (p=0.039). The cryobiopsies whose anatomopathological result was positive for malignancy were solid lesions in all cases. The use of cryoprobe did not increase the procedure time and no bleeding, pneumothorax or other relevant complications were recorded (fig 2). <bold>Conclusions:</bold> The use of the cryoprobe in ENB (Illumisite TM®) improves the diagnostic performance of peripheral lung lesions. Further studies are needed to determine which types of nodules can benefit from different diagnostic techniques using ENB.