VIDEOTHORACOSCOPIC LUNG-BIOPSY IN DIFFUSE INFILTRATIVE LUNG-DISEASES - A 5-YEAR SURGICAL EXPERIENCE

Background. To establish an accurate diagnosis of diffuse infiltrative lung disease, a surgical lung biopsy may be required. We report our e xperience with videothoracoscopic lung biopsy over a period of 5 years . Methods. From March 1992 through December 1996, videothoracoscopic l ung biopsy was performed in 64 patients (17 were women [26.5%]; age, 5 0.5 +/- 13 years) with a diagnosis of diffuse infiltrative lung diseas e of an unknown cause. All patients except one received general anesth esia. Single lung ventilation was used in 61 patients. All lung biopsi es were obtained with an endoscopic stapler. Results. Single lung biop sies were performed in 39 patients (61%), two biopsies in 23 patients (36%), and three biopsies in 2 patients. Minithoracotomies were necess ary in 10 patients (15.6%) owing to an iatrogenic pulmonary wound (1 p atient), extensive pleural adhesions (6 patients), and a stiff lung (3 patients). Postoperative complications were rare and included five di screte pneumothoraces (7.8%), all resolving spontaneously, one prolong ed air leak (1.6%), and one hemothorax requiring reoperation. Three pr eoperatively debilitated patients died (4.7%), 2 with progression of r espiratory failure and 1 owing to septic shock. Average chest tube dur ation was 2.4 +/- 2 days and average hospital stay was 4.6 +/- 2.5 day s. Lung biopsy contributed to the diagnosis in 59 patients (92%). Conc lusions. Videothoracoscopic lung biopsy using an endoscopic stapler is a safe and effective procedure in most cases and should be performed by trained thoracic surgeons. (Ann Thorac Surg 1998;66:1170-3) (C) 199 8 by The Society of Thoracic Surgeons.