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Hot and Cold Biopsy Forceps in the Diagnosis of Endobronchial Lesions

This study has been completed.
Sponsor:
ClinicalTrials.gov Identifier:
NCT00963716
First Posted: August 21, 2009
Last Update Posted: August 21, 2009
The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details.
Information provided by:
Postgraduate Institute of Medical Education and Research
  Purpose
A new electrocautery bronchoscopy biopsy forceps is now commercially available and may prevent bleeding following biopsy. Only one study used this device wherein the authors concluded that the use of hot biopsy forceps for endobronchial biopsy does not appear to have a negative impact on the pathological samples, and that there was a statistically significant, albeit clinically insignificant reduction in bleeding score with hot biopsy forceps. Therefore, a randomized controlled study is required in which the hot and cold biopsies are performed to evaluate the tissue effect of the hot biopsy forceps on histopathological diagnosis.

Condition Intervention
Endobronchial Growth Lung Cancer Device: Hot biopsy forceps Device: Cold biopsy forceps

Study Type: Interventional
Study Design: Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary Purpose: Diagnostic
Official Title: Hot and Cold Biopsy Forceps in the Diagnosis of Endobronchial Lesions

Resource links provided by NLM:


Further study details as provided by Postgraduate Institute of Medical Education and Research:

Primary Outcome Measures:
  • Quality of pathological specimen [ Time Frame: 4 hours ]

Secondary Outcome Measures:
  • Severity of bleeding [ Time Frame: During procedure ]

Enrollment: 168
Study Start Date: November 2007
Study Completion Date: July 2009
Primary Completion Date: July 2009 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Hot biopsy
Hot biopsy i.e. Endobronchial biopsies taken with the application of an electrocoagulation current by an electrocoagulation-capable biopsy forceps
Device: Hot biopsy forceps
Endobronchial biopsies taken with the application of an electrocoagulation current by an electrocoagulation-capable biopsy forceps
Other Name: Hot biopsy
Active Comparator: Cold biopsy
Cold biopsy i.e. Endobronchial biopsies taken without the application of an electrocoagulation current by an electrocoagulation-capable biopsy forceps
Device: Cold biopsy forceps
Endobronchial biopsies taken without the application of an electrocoagulation current by an electrocoagulation-capable biopsy forceps
Other Name: Cold biopsy

Detailed Description:

In recent years, a number of innovative non-thoracotomy techniques have been introduced for the diagnosis of indeterminate pulmonary disease but none has had greater impact on pulmonary medicine than flexible fiberoptic bronchoscopy. Since its introduction in 1968, fiberoptic bronchoscopy has become the procedure of choice for diagnosis and management of many bronchopulmonary disorders. It is accompanied by a low incidence of complications and can be performed satisfactorily by the transnasal approach without general anesthesia. Donlan et al, in 1978, and Ackart and colleagues, in 1983, demonstrated the safety of fiberoptic bronchoscopy as an outpatient procedure.

Transbronchial biopsy was first attempted, through a rigid bronchoscope in 1965, but was associated with a high occurrence of pneumothorax. Reports began to appear from 1974 onwards of lung biopsies done for diffuse pulmonary disease using the standard fiberoptic bronchoscope. Forceps biopsy through flexible bronchoscopy is commonly used to make the cytological or histological diagnosis. Of the procedures performed through bronchoscopy, forceps biopsy provides the best diagnostic yield of 71% to 93%.

A new electrocautery ''hot'' bronchoscopy biopsy forceps is now commercially available and may prevent bleeding following biopsy. Only one study used this device wherein the authors concluded that the use of hot biopsy forceps for endobronchial biopsy does not appear to have a negative impact on the pathological samples, and that there was a statistically significant (albeit clinically insignificant) reduction in bleeding score with hot biopsy forceps. However, limitations in this study were small sample size, use of hot and cold biopsy in the same patient as well as interval between the two biopsies were short due to which it is difficult to decide which technique has contributed to the bleeding. Therefore, a randomized controlled study is required in which the hot and cold biopsies are performed to evaluate the tissue effect of the hot biopsy forceps on histopathological diagnosis.

  Eligibility

Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years and older   (Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  1. All patients undergoing routine bronchoscopic biopsy for various indications
  2. More than 18 years of age

Exclusion Criteria:

  1. Bleeding diathesis
  2. On pacemaker or implanted defibrillator
  3. On anticoagulation therapy
  4. Poor cardiopulmonary reserve
  5. Marked hypoxemia
  6. Uncooperative patient
  7. Enrollment in the previous study
  Contacts and Locations
Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT00963716


Locations
India
Department of Pulmonary Medicine, PGIMER, India
Chandigarh, UT, India, 160012
Sponsors and Collaborators
Postgraduate Institute of Medical Education and Research
Investigators
Study Chair: Ashutosh N Aggarwal, MD, DM, FCCP PGIMER, Chandigrh
  More Information

Responsible Party: Ajmal khan, Postgraduate Institute of Medical Education and Research
ClinicalTrials.gov Identifier: NCT00963716     History of Changes
Other Study ID Numbers: Khan-1
First Submitted: August 18, 2009
First Posted: August 21, 2009
Last Update Posted: August 21, 2009
Last Verified: August 2009

Keywords provided by Postgraduate Institute of Medical Education and Research:
endobronchial biopsy
bronchoscopy
interventional pulmonology