PMID- 34222336 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20210706 IS - 2296-889X (Print) IS - 2296-889X (Electronic) IS - 2296-889X (Linking) VI - 8 DP - 2021 TI - 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. PG - 681669 LID - 10.3389/fmolb.2021.681669 [doi] LID - 681669 AB - 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. CI - Copyright (c) 2021 Han, Chen, Xu, Qian, Zhao, Mao, Guo, Xia, Peng, He, Gu, Li and Luo. FAU - Han, Qian AU - Han Q AD - Department of Respiratory Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China. AD - National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, China. FAU - Chen, Xiaobo AU - Chen X AD - Department of Respiratory Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China. AD - National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, China. FAU - Xu, Xin AU - Xu X AD - National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, China. AD - Department of Cardio-thoracic Surgery, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China. FAU - Qian, Weiping AU - Qian W AD - Department of Respiratory Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China. AD - National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, China. FAU - Zhao, Gui AU - Zhao G AD - Department of Respiratory Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China. AD - National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, China. FAU - Mao, Mengmeng AU - Mao M AD - Department of Respiratory Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China. AD - National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, China. FAU - Guo, Bingpeng AU - Guo B AD - Department of Respiratory Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China. AD - National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, China. FAU - Xia, Shu AU - Xia S AD - Department of Respiratory Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China. AD - National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, China. FAU - Peng, Guilin AU - Peng G AD - National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, China. AD - Department of Cardio-thoracic Surgery, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China. FAU - He, Jianxing AU - He J AD - National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, China. AD - Department of Cardio-thoracic Surgery, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China. FAU - Gu, Yingying AU - Gu Y AD - National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, China. AD - Department of Pathology, Guangzhou Institute of Respiratory Health, Guangzhou, China. FAU - Li, Shiyue AU - Li S AD - Department of Respiratory Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China. AD - National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, China. FAU - Luo, Qun AU - Luo Q AD - Department of Respiratory Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China. AD - National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, China. LA - eng PT - Journal Article DEP - 20210616 PL - Switzerland TA - Front Mol Biosci JT - Frontiers in molecular biosciences JID - 101653173 PMC - PMC8241905 OTO - NOTNLM OT - cryobiopsy OT - interstitial lung disease OT - multidisciplinary diagnosis OT - pathological diagnosis OT - uniportal and tubeless video-assisted thoracic surgery COIS- The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. EDAT- 2021/07/06 06:00 MHDA- 2021/07/06 06:01 PMCR- 2021/01/01 CRDT- 2021/07/05 10:14 PHST- 2021/03/17 00:00 [received] PHST- 2021/06/02 00:00 [accepted] PHST- 2021/07/05 10:14 [entrez] PHST- 2021/07/06 06:00 [pubmed] PHST- 2021/07/06 06:01 [medline] PHST- 2021/01/01 00:00 [pmc-release] AID - 681669 [pii] AID - 10.3389/fmolb.2021.681669 [doi] PST - epublish SO - Front Mol Biosci. 2021 Jun 16;8:681669. doi: 10.3389/fmolb.2021.681669. eCollection 2021.