Interest of in Situ Terlipressin Administration Before the Realisation of Bronchial Biopsy
Status:
Unknown status
Trial end date:
2020-02-01
Target enrollment:
Participant gender:
Summary
The diagnostic yield of flexible bronchoscopy for the diagnosis of lung cancer depends on the
location and the histological type of the lesion, as well as on the number of biopsy samples
performed. The increasing number of sampling is also important to provide material for
molecular assessment of lung cancer. The French National Institute for Cancer recommends a
number of 5 biopsies in order to reach a diagnostic yield of 88%. However, as increasing the
number of bronchial biopsies comes with a higher risk of bleeding, the management of
endobronchial bleeding may be determinant for the diagnostic yield.
The most recent recommendations of the British Thoracic Society for the management of
bronchial bleeding, after bronchial or transbronchial biopsy, are to inject 5 to 10 mL of
1/10000 diluted adrenalin, or cold saline serum (04°C.). The French guidelines also include
the use of endobronchial terlipressin, which has local vasoconstriction effect. After
endobronchial administration of terlipressin, plasmatic concentrations are low, and are not
clinically relevant.
The hypothesis of this clinical trial is that endobronchial instillation of terlipressin
before sampling endobronchial tumor will limit the endobronchial bleeding and allow to
increase the number of biopsies performed and, eventually, the diagnostic yield.