TY - JOUR T1 - Learning curve for transbronchial lung cryobiopsy in diffuse lung disease JO - Pulmonology T2 - AU - Almeida,L.M. AU - Lima,B. AU - Mota,P.C. AU - Melo,N. AU - Magalhães,A. AU - Pereira,J.M. AU - Moura,C.S. AU - Guimarães,S. AU - Morais,A. SN - 25310437 M3 - 10.1016/j.rppnen.2017.09.005 DO - 10.1016/j.rppnen.2017.09.005 UR - https://www.journalpulmonology.org/en-learning-curve-for-transbronchial-lung-articulo-S2173511517301483 AB - IntroductionTransbronchial lung cryobiopsy (TBLC) is increasingly used in the diagnosis of diffuse lung disease (DLD), but no data have yet been published on the learning curve associated with this technique. AimTo evaluate diagnostic yield, lung tissue sample length and area, and procedure-related complications in a cohort of TBLC procedures to define the learning curve and threshold for proficiency. MethodsRetrospective analysis of the first 100 TBLCs performed in different segments of the same lobe in patients with suspected DLD. We compared diagnostic yield, sample length and area, and complications between consecutive groups of patients. ResultsThe overall diagnostic yield for TBLC was 82%. Median sample length was 5.4mm (IQR, 5–6) and median area was 19.5mm2 (IQR, 13.3–25). Pneumothorax was the most common complication (18%). On comparing the two groups of 50 consecutive patients, a significant difference was found for diagnostic yield (74% vs 90%; p=0.04), sample length (5.0mm [2.5–16] vs 6.0mm [4–12;] p<0.01) and area (17.5mm2 [6–42] vs 21.5mm2 [10–49]; p<0.01). Logarithm regression was applied to median diagnostic yield and sample length and area for groups of 10 consecutive patients to define the learning curve, which plateaued after approximately 70 procedures. ConclusionsOur findings suggest that proficiency in TBLC is achieved at approximately the 70th procedure; however they need to be validated in more series and cohorts. ER -