Comparison between different types of forceps used in transbronchial lung biopsy

Background: Transbronchial lung biopsy (TBBX) is a common respiratory diagnostic procedure performed to investigate several lung diseases. There are different types of forceps available that may be used to perform this procedure. The Alligator and the Cup forceps are the most commonly used ones. To date, there are very few studies that have compared the efficacy of these two types of forceps. This study compared the two types of forceps in term of complications rate, diagnostic value and the biopsy sizes. Methods: It was a retrospective observational study. A total of 80 patients involved in the study. 40 patients underwent TBBX using the alligator forceps were compared to the previous 40 patients who had the same procedure using the cupped forceps. The two groups compared with respect to the rate of complications (bleeding and pneumothorax) and the diagnostic value of the biopsies. Results: The complications rate was significantly higher in the patients underwent the TBBX using the Alligator forceps: 7 patients (17.5%) had significant bleeding versus 4 patients (10%) in the Cupped forceps group. Pneumothorax developed in 3 patients (7.5%) of the Alligator forceps group, while no patients had it in the cupped forceps group. The diagnostic yield was higher in the cupped forceps group: 18 patients (45%) had diagnostic samples versus 15 patients (37.5%) in the Alligator forceps group. The mean biopsies size was 1.83mm in the cupped forceps group and 1.98mm in the alligator forceps group. Conclusions: The results of our study suggested that using the Cupped forceps is associated with significantly less complications (pneumothorax and bleeding) and has better diagnostic yield in comparison to the Alligator forceps.