Yield of Cryoprobe vs Flexible Forceps Pleural Biopsy (COFFEE)
Primary Purpose
Pleural Effusion, Pleurisy, Tuberculosis
Status
Completed
Phase
Not Applicable
Locations
India
Study Type
Interventional
Intervention
Cryoprobe pleural biopsy first
Flexible forceps biopsy first
Sponsored by
About this trial
This is an interventional diagnostic trial for Pleural Effusion focused on measuring thoracoscopy, pleuroscopy, semirigid thoracoscopy, flexible cryoprobe, cryobiopsy, pleural biopsy
Eligibility Criteria
Inclusion Criteria:
- Age ≥12 years
- Semirigid thoracoscopy being performed for diagnosis of the pleural effusion
Exclusion Criteria:
- Age ≥80 years
- SpO2 <88% on room air
- Hemodynamic instability
- Myocardial infarction or unstable angina in the last 6 wk
- Lack of pleural space due to adhesions
- Uncorrected coagulopathy
- Failure to provide informed consent
Sites / Locations
- PGIMER
Arms of the Study
Arm 1
Arm 2
Arm Type
Active Comparator
Active Comparator
Arm Label
Cryobiopsy
Forceps biopsy
Arm Description
Pleural biopsy with a flexible cryoprobe
Pleural biopsy with a flexible forceps
Outcomes
Primary Outcome Measures
Yield of pleural biopsy obtained with the routine flexible thoracoscopic biopsy forceps versus that obtained with a flexible cryoprobe during semirigid thoracoscopy
The proportion of patients where a definitive histopathological diagnosis was obtained will be compared between the cryoprobe and flexible forceps biopsy
Secondary Outcome Measures
Biopsy size
Size of biopsy specimens obtained with the two techniques
Duration of procedure
Time taken for the procedure with the two techniques
Ease of biopsy VAS
Ease of taking biopsy with the two techniques assessed using a visual analog scale
Artifacts
Number of patient speciemens with histopathologic artifacts with either technique including crush artefacts with the flexible forceps and freeze artifacts with the cryoprobe
Tissue depth
Depth of the tissue obtained on histopathology
Bleeding
Number of participants with bleeding seen while taking biopsy categorised into "no bleeding", "minimal self limited ooze", "bleeding requiring prolonged suctioning" , "major hemorrhage requiring blood transfusion, causing hemodynamic instability or ICU admission"
Full Information
NCT ID
NCT02500277
First Posted
July 13, 2015
Last Updated
August 29, 2018
Sponsor
Postgraduate Institute of Medical Education and Research
1. Study Identification
Unique Protocol Identification Number
NCT02500277
Brief Title
Yield of Cryoprobe vs Flexible Forceps Pleural Biopsy
Acronym
COFFEE
Official Title
A Study to Evaluate the Yield of Pleural Biopsy With a Flexible Cryoprobe Versus Flexible Forceps During Semirigid Thoracoscopy: a Comparative Study
Study Type
Interventional
2. Study Status
Record Verification Date
August 2018
Overall Recruitment Status
Completed
Study Start Date
January 2015 (undefined)
Primary Completion Date
July 2018 (Actual)
Study Completion Date
July 2018 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Postgraduate Institute of Medical Education and Research
4. Oversight
Data Monitoring Committee
No
5. Study Description
Brief Summary
This is a prospective study to assess the yield of pleural biopsy obtained with the routine flexible thoracoscopic biopsy forceps versus that obtained with a flexible cryoprobe during semirigid thoracoscopy
Detailed Description
Consecutive patients with exudative pleural effusions who are planned to undergo semirigid thoracoscopy will be enrolled in the study if they satisfy the inclusion criteria. They will be randomized in 1:1 ratio using a computer-generated randomization sequence to the following groups:
Group A: Four pleural biopsy specimens obtained using the flexible cryoprobe followed by eight pleural biopsy specimens obtained using the flexible thoracoscopic forceps OR Group B: The above two procedures will be performed in the reverse order The biopsies will be performed from different areas of the involved pleura with the two techniques. Thoracoscopy will be performed in the bronchoscopy suite on spontaneously breathing subjects (fasting for 8 h) under conscious sedation (using midazolam, pentazocine, and tramadol) observing complete aseptic precautions.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Pleural Effusion, Pleurisy, Tuberculosis, Metastatic Malignancy
Keywords
thoracoscopy, pleuroscopy, semirigid thoracoscopy, flexible cryoprobe, cryobiopsy, pleural biopsy
7. Study Design
Primary Purpose
Diagnostic
Study Phase
Not Applicable
Interventional Study Model
Crossover Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
50 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Cryobiopsy
Arm Type
Active Comparator
Arm Description
Pleural biopsy with a flexible cryoprobe
Arm Title
Forceps biopsy
Arm Type
Active Comparator
Arm Description
Pleural biopsy with a flexible forceps
Intervention Type
Device
Intervention Name(s)
Cryoprobe pleural biopsy first
Intervention Description
Four pleural biopsy specimens will be obtained using the flexible cryoprobe (ERBOCRYOCA, ERBE, Tubingen, Germany; outer diameter 1.9 mm, length 900 mm) followed by 6-10 pleural biopsy specimens obtained using the flexible thoracoscopic forceps (FB-55CR, Olympus Medical Systems, 2 mm diameter).
Intervention Type
Device
Intervention Name(s)
Flexible forceps biopsy first
Intervention Description
Six to ten pleural biopsy specimens will be obtained using the flexible thoracoscopic forceps (FB-55CR, Olympus Medical Systems, 2 mm diameter) followed by four pleural biopsy specimens obtained using the flexible cryoprobe (ERBOCRYOCA, ERBE, Tubingen, Germany; outer diameter 1.9 mm, length 900 mm)
Primary Outcome Measure Information:
Title
Yield of pleural biopsy obtained with the routine flexible thoracoscopic biopsy forceps versus that obtained with a flexible cryoprobe during semirigid thoracoscopy
Description
The proportion of patients where a definitive histopathological diagnosis was obtained will be compared between the cryoprobe and flexible forceps biopsy
Time Frame
One week
Secondary Outcome Measure Information:
Title
Biopsy size
Description
Size of biopsy specimens obtained with the two techniques
Time Frame
One day
Title
Duration of procedure
Description
Time taken for the procedure with the two techniques
Time Frame
One day
Title
Ease of biopsy VAS
Description
Ease of taking biopsy with the two techniques assessed using a visual analog scale
Time Frame
One day
Title
Artifacts
Description
Number of patient speciemens with histopathologic artifacts with either technique including crush artefacts with the flexible forceps and freeze artifacts with the cryoprobe
Time Frame
One day
Title
Tissue depth
Description
Depth of the tissue obtained on histopathology
Time Frame
One day
Title
Bleeding
Description
Number of participants with bleeding seen while taking biopsy categorised into "no bleeding", "minimal self limited ooze", "bleeding requiring prolonged suctioning" , "major hemorrhage requiring blood transfusion, causing hemodynamic instability or ICU admission"
Time Frame
One day
10. Eligibility
Sex
All
Minimum Age & Unit of Time
12 Years
Maximum Age & Unit of Time
79 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Age ≥12 years
Semirigid thoracoscopy being performed for diagnosis of the pleural effusion
Exclusion Criteria:
Age ≥80 years
SpO2 <88% on room air
Hemodynamic instability
Myocardial infarction or unstable angina in the last 6 wk
Lack of pleural space due to adhesions
Uncorrected coagulopathy
Failure to provide informed consent
Facility Information:
Facility Name
PGIMER
City
Chandigarh
ZIP/Postal Code
160012
Country
India
12. IPD Sharing Statement
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