Abstract
Introduction. Disseminated lung diseases (DLD) encompass a wide range of pathologies characterized by diffuse changes in both lungs. Despite the high level of informativeness (94–100%) of surgical video-assisted thoracoscopic (VATS) biopsy, the risk of serious complications and mortality associated with this procedure drives the search for safer yet sufficiently accurate alternatives. Bronchoscopic biopsy (forceps and cryobiopsy) leads to fewer complications; however, its diagnostic value remains inconsistent (16–80%). One promising avenue for improving the accuracy of this minimally invasive approach is the use of confocal laser endomicroscopy (CLE) to guide bronchoscopic biopsy. Objective. To conduct a preliminary assessment of the diagnostic value of CLE in guiding and selecting the target site for transbronchial forceps biopsy. Material and methods. A single-center prospective randomized study. Eligibility criteria: age over 18 years with multiple lung lesions observed in more than two segments on chest CT. Exclusion criteria: any confirmed disease at the time of examination, specifically HIV infection and/or any kind of malignant neoplasm, or patient refusal. The study included 170 patients in the main group and 192 in the control group. Results. The diagnostic yield was 97.1% in the main group and 78.1% in the control group (p<0.05). Complications included pulmonary hemorrhage in 2.6% of the main group and 2.08% of the control group (p>0.05), and pneumothorax in 1.0% of the main group and 1.56% of the control group (p>0.05). Conclusion. The use of CLE for navigation in transbronchial lung biopsy significantly increases the diagnostic yield without raising the overall complication rate, making it feasible to continue and further develop this method.