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Marie Dominique Destable
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Ann Thorac Surg 1998;66:1170-1173
© 1998 The Society of Thoracic Surgeons

Original articles: general thoracic

Videothoracoscopic lung biopsy in diffuse infiltrative lung diseases: a 5-year surgical experience

Rachid Zegdi, MDa, Jacques Azorin, MDa, Bruno Tremblay, MDa, Marie Dominique Destable, MDa, Paul S. Lajos, MDa, Dominique Valeyre, MDb

a Department of Thoracic and Vascular Surgery, Avicenne Hospital, Bobigny, France
b Department of Pulmonary Medicine, Avicenne Hospital, Bobigny, France

Accepted for publication May 3, 1998.

Address reprint requests to Dr Zegdi, Department of Thoracic and Cardiovascular Surgery, Hôpital Broussais, 96 rue Didot, 75014 Paris, France

Abstract

Background. To establish an accurate diagnosis of diffuse infiltrative lung disease, a surgical lung biopsy may be required. We report our experience with videothoracoscopic lung biopsy over a period of 5 years.

Methods. From March 1992 through December 1996, videothoracoscopic lung biopsy was performed in 64 patients (17 were women [26.5%]; age, 50.5 ± 13 years) with a diagnosis of diffuse infiltrative lung disease of an unknown cause. All patients except one received general anesthesia. Single lung ventilation was used in 61 patients. All lung biopsies were obtained with an endoscopic stapler.

Results. Single lung biopsies were performed in 39 patients (61%), two biopsies in 23 patients (36%), and three biopsies in 2 patients. Minithoracotomies were necessary in 10 patients (15.6%) owing to an iatrogenic pulmonary wound (1 patient), extensive pleural adhesions (6 patients), and a stiff lung (3 patients). Postoperative complications were rare and included five discrete pneumothoraces (7.8%), all resolving spontaneously, one prolonged air leak (1.6%), and one hemothorax requiring reoperation. Three preoperatively debilitated patients died (4.7%), 2 with progression of respiratory failure and 1 owing to septic shock. Average chest tube duration was 2.4 ± 2 days and average hospital stay was 4.6 ± 2.5 days. Lung biopsy contributed to the diagnosis in 59 patients (92%).

Conclusions. Videothoracoscopic lung biopsy using an endoscopic stapler is a safe and effective procedure in most cases and should be performed by trained thoracic surgeons.




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