Videothoracoscopic lung biopsy in the diagnosis of interstitial lung disease

Objective: Interstitial lung diseases (ILD) require lung biopsy for the dia gnosis in more than 30% of patients. Open lung biopsy (OLB) was generally c onsidered the most reliable method of biopsy and tissue diagnosis. This stu dy tests the diagnostic accuracy and safety of thtr videothoracoscopic lung biopsy (VTLB) in the diagnosis of TLD. Methods: During the last 5 years, 5 8 patients were submitted to VTLB under general anesthesia. The mean age wa s 49.6 +/- 12.0 years (range 21-69). All the biopsies were performed by an endostapler EndoPath 30 or 45. Conversion to minithoracotomy was necessary in only one patient because of extensive pleural sinfisis. All the specimen s were sent to the microbiology and pathology department for microbiologica l and histopathological diagnosis. One chest-tube (28F) was positioned and connected to a drainage-system and placed on suction. Results: The histopat hological diagnosis was obtained for all patients and therefore the diagnos tic accuracy of the procedure was 100%. No postoperative haemothorax occurr ed and only two patients experienced a prolonged air-leakage (3.4%). The me dian duration of the chest-drain was 3 days (range 1-7) and the median hosp ital stay was 4 days (range 2-7). Conclusion: VTLB provides adequate specim en volume for histopathologic diagnosis and achieves a very high diagnostic accuracy (100% in our series). The postoperative morbidity and mortality r ates are lower than those related to OLB. We conclude that VTLB is an effec tive and safe procedure in the diagnosis of ILD. (C) 1999 Elsevier Science B.V. All rights reserved.