EFFICACY AND SAFETY OF VIDEOTHORACOSCOPIC LUNG-BIOPSY IN THE DIAGNOSIS OF INTERSTITIAL LUNG-DISEASE

Objective: The aim of this study was to determine the efficacy and saf ety of videothoracoscopic lung biopsy (VTLB) in the diagnosis of infil trative lung disease (ILD) and compare the results of VTLB with the re sults previously obtained in patients with open lung biopsy at the sam e institution. Methods: Forty-one patients undergoing VTLB between May 1991 and December 1994 were retrospectively studied and compared with 25 patients who have undergone OLB during the period from January 198 7 to April 1991. The two groups were comparable with respect to age, s ex, and severity of lung disease, Results: Three of 41 patients (7%) w ho underwent VTLB with minithoracotomy. There was no significant diffe rence between the group of VTLB (38 patients) and the group OLB (25 pa tients) with regard to, the number of biopsies (VTLB 1.8 +/- 0.4 versu s OLB 2 +/- 0.6), or diagnostic yield (VTLB 37/38 versus OLB 25/25). I n contrast, patients who underwent VTLB demonstrated a significant red uction of the operative time (VTLB 45.3 +/- 12.2 min), length of chest tube drainage (3.55 +/- 1.2 days), hospital stay (5.5 +/- 1.3 days), and analgesia (buprenorphine 0.85 +/- 0.44 mg; paracetamol 5.9 +/- 2.5 g) compared to patients who underwent OLB (55.6 +/- 11.2 min, 5.2 +/- 1.5 days; 7.1 +/- 2.3 days; buprenorphine 1.17 +/- 0.5 mg, paracetamo l 8.9 +/- 2.3 g). Morbidity and mortality were similar in the two grou ps (morbidity VTLB 10.5%, OLB 12%; mortality VTLB 5.2%, OLB 8%). Regar dless of the biopsy technique, the most serious complications and deat hs occurred with the same frequency in those patients with a severe un derlying disease. Conclusions: VTLB is a valid alternative to OLB in m ost cases. Along with a comparable efficacy, VTLB has several advantag es that should make it the method of choice for patients with only min imally impaired respiratory function. In contrast, the role and advant ages of VTLB compared to OLB in patients with severe lung disease, req uire further investigation. Copyright (C) 1997 Elsevier Science B.V.