The effect of forceps type on results and complications of transbronchial lung biopsy

Background: Lung biopsy via the bronchus (TBLB) is among the routine diagnostic procedures for pulmonary diseases and is performed using either of two different kinds of forceps: cup and alligator. Objective: The purpose of this study was to compare the efficacy of two kinds of forceps on quality of biopsy as well as the side effects of TBLB. Methods: This was a prospective, observational and double-blind study in which four samples were biopsied from each patient via TBLB. The sample characteristics were recorded based on size, number of alveoli included, diagnostic value, and the side effects such as pneumothorax and bleeding. Findings: A total number of 44 patients and 176 biopsies were evaluated. Twenty one patients (47.7%) were males and 23 (52.3%) females. While considering the size of samples, of 88 biopsies via alligator forceps, 21.6% were small, 45.5% medium, and 33% large. Corresponding results for the cup forceps were 43.2% small, 29.5% medium, and 27.3% large. From 88 biopsies taken using alligator forceps, 18.2% were found to have diagnostic value whereas in the case of cup forceps the diagnostic value was 23.9%. While no significant pneumothorax was seen with alligator forceps it was observed in 9% of the cup forceps procedures. Significant bleeding was seen in 1% of the alligator forceps and 5.7% of the cup forceps procedures. Conclusion: Comparing two types of forceps regarding the effect on results of TBLB, alligator forceps produced larger samples and less side effects. There was no significant difference in diagnostic value between two procedures.