Rigid thoracoscopy is the gold standard tool for diagnosing exudative pleural effusion, but sometimes it is difficult to obtain sufficient biopsies using the conventional forceps. This study evaluated the efficacy, safety, and diagnostic value of a modified technique using cryoprobe to obtain pleural biopsies during thoracoscopy. This is a single-center prospective study in patients that underwent rigid thoracoscopy using conventional rigid forceps followed by a cryoprobe at the same setting after injection of subpleural mixture of adrenaline and xylocaine. Biopsies were reviewed by an independent pathologist; any complications were recorded, and all patients were followed-up post-procedure. Twenty-four patients (12 males; mean age was 56 ± 15.1years) were included. The diagnostic yield of both rigid forceps biopsy (RFB) and cryoprobe biopsy (CPB) was 100%. CPB had more surface area than RFB with no difference regarding largest diameter (p = 0.064). RFB and CPB had similar results regarding presence of fat cells. CPB had much less crushed cells than RFB with better tissue preservation (p = 0.004). No significant complications were reported. The modified cryoprobe biopsy is a highly effective and safe way for obtaining pleural biopsy besides affording good quality and size of the biopsy especially in thick firmly adherent pleura.

中文翻译：

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改良胸腔镜胸腔穿刺活检诊断病因不明的渗出性胸腔积液

硬性胸腔镜检查是诊断渗出性胸腔积液的金标准工具，但有时使用传统的钳子很难获得足够的活检物。这项研究评估了使用冷冻探头在胸腔镜检查中获取胸膜活检的改良技术的功效，安全性和诊断价值。这是一项针对单中心的前瞻性研究，研究对象是在注射胸膜下注射肾上腺素和二甲苯卡因后，使用传统的硬性镊子进行硬性胸腔镜检查，然后在相同设置下进行冷冻探针检查的患者。活检由独立的病理学家进行；记录任何并发症，并对所有患者进行术后随访。包括二十四名患者（12名男性；平均年龄为56±15.1岁）。硬性钳活检（RFB）和冷冻探针活检（CPB）的诊断率均为100％。CPB比RFB具有更大的表面积，最大直径没有差异（p = 0.064）。对于脂肪细胞的存在，RFB和CPB的结果相似。CPB的碎裂细胞比RFB少得多，组织保存效果更好（p = 0.004）。没有重大并发症的报道。改良的冷冻探针活检是获得胸膜活检的一种高效且安全的方法，除了提供良好的质量和大小的活检，尤其是在厚而牢固附着的胸膜中。没有重大并发症的报道。改良的冷冻探头活检是获得胸膜活检的一种非常有效和安全的方法，除了可以提供良好的质量和大小的活检，尤其是在厚而牢固附着的胸膜中。没有重大并发症的报道。改良的冷冻探针活检是获得胸膜活检的一种高效且安全的方法，除了提供良好的质量和大小的活检，尤其是在厚而牢固附着的胸膜中。