Back to 2014 Annual Meeting Posters
Videothoracoscopic lung biopsy in the diagnosis of interstitial lung disease: how many biopsies?
Francesco Quarantotto, Pio Maniscalco, Nicola Tamburini, Elena Garelli, William Grossi, Giorgio Cavallesco.
Department General and Thoracic surgery, Ferrara, Italy.
OBJECTIVE: Interstitial lung disease (ILD) is a generic term representing a heterogeneous group of lung disease sharing clinical, roentgenographic, and physiologic features. Surgery may still be needed to establish an accurate diagnosis, to identify potential treatable causes and to rule out other process. Video-assisted thoracoscopic surgery (VATS) has been recently adopted as a safe and effective approach in obtaining biopsies of parenchymal lung disease. It is not clear the number of biopsies required to obtain a diagnosis of certainty. This study tests the diagnostic accuracy and safety of the videothoracoscopic lung biopsy in the diagnosis of ILD.
METHODS: A retrospective study was conducted of 47 consecutive patients with suspected interstitial lung disease (ILD) on clinical and radiological grounds referred for VATS biopsy during a 5-year period (from January 2005 to December 2010). The mean age was 59.3 +/- 12.0 years (range 27-80). Pulmonary function tests, chest high resolution computer tomography scan, bronchoscopy and bronchoalveolar lavage (BAL) were carried out in all patients. A suitable biopsy site was chosen using chest HRCT-scan abnormalities and intraoperative findings. All the specimens were sent to the microbiology and pathology department for microbiological and histopathological diagnosis. One chest-tube (28F) was positioned and connected to a drainage-system and placed on suction.
RESULTS: Twenty-three 23 patients (49%) one biopsy was performed, multiple biopsies (two or three) were carried out in 24 patients (51%). The histopathological diagnosis was obtained for all patients and therefore the diagnostic accuracy of the procedure was 100%. Postoperative mortality rate was 0 %. The mean and median post-operative stay was 3.1 days. The postoperative complications were very rare. Two patients (4%) experienced a prolonged air-leak.
CONCLUSIONS: Videothoracoscopic lung biopsy provides adequate specimen volume for histopathologic diagnosis and achieves a very high diagnostic yield. A very high diagnostic accuracy can be achieved also in case of single biopsy by targeting the site using chest HRCT-scan.
Back to 2014 Annual Meeting Posters