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Ann Thorac Surg 2008;86:1098-1103. doi:10.1016/j.athoracsur.2008.06.021
© 2008 The Society of Thoracic Surgeons
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Hyun Koo Kim
Won-Min Jo
Jae Ho Jung
Won Jae Chung
Jae Hoon Shim
Young Ho Choi
In Sung Lee
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Original Articles: General Thoracic

Needlescopic Lung Biopsy for Interstitial Lung Disease and Indeterminate Pulmonary Nodules: A Report on 65 Cases

Hyun Koo Kim, MD, PhDa, Won-Min Jo, MD, PhDb,*, Jae Ho Jung, MDb, Won Jae Chung, MDb, Jae Hoon Shim, MDa, Young Ho Choi, MD, PhDa, In Sung Lee, MD, PhDb

a Department of Thoracic and Cardiovascular Surgery, College of Medicine, Korea University Guro Hospital, Seoul, Republic of Korea
b Department of Thoracic and Cardiovascular Surgery, College of Medicine, Korea University Ansan Hospital, Kyonggi-do, Republic of Korea

Accepted for publication June 2, 2008.

* Address correspondence to Dr Jo, Department of Thoracic and Cardiovascular Surgery, Ansan Hospital, Korea University, Gojan-1-dong, Ansan-si, Kyonggi-do, 425-707, Rep of Korea (Email: jowonmin{at}korea.ac.kr).

Background: We evaluated the feasibility and accuracy of a needlescopic procedure for lung biopsies in patients with interstitial lung disease or indeterminate pulmonary nodules.

Methods: Sixty-five patients (36 women; mean age, 51.3 ± 15.6; range, 13 to 76 years) underwent a needlescopic procedure to obtain lung biopsy specimens. Forty had indeterminate pulmonary nodules, and 25 had interstitial lung disease. A 2-mm needlescope and a 2-mm MiniSite Endo Grasp (Covidien, Norwalk, CT) were inserted at the sixth intercostal space along the middle and the posterior axillary line, respectively. Biopsy specimens were obtained using endostaplers.

Results: The average number of biopsy specimens was 1.7 ± 0.6 (range, 1 to 4). For 9 patients, a frozen specimen was sent twice to pathology. Complete resection was continued after intraoperative pathology confirmation in 13 patients (lobectomy, 7; segmentectomy, 3; mass removal, 1; metastasectomy, 2). The volume of lung tissue was 8.7 ± 11.8 cm3 (range, 0.15 to 55.44 cm3). The operation time was 58.7 ± 37.5 minutes (range, 15 to 160 minutes). The final pathologic results were confirmed in all patients. No thoracoscopic procedure was converted to an open thoracotomy. Three patients (4.3%) had prolonged air leakage (> 5 days), and the chest tube remained in the pleural space for 2.3 ± 2.4 days (range, 1 to 8 days).

Conclusions: Needlescopic operation for lung biopsies in patients with interstitial lung disease and indeterminate pulmonary nodules is a minimally invasive procedure that is safe and effective for obtaining a diagnosis in selected patients.


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Invited Commentary
Todd L. Demmy
Ann. Thorac. Surg. 2008 86: 1103. [Extract] [Full Text] [PDF]



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 Ann. Thorac. Surg.Home page
T. L. Demmy
Invited Commentary
Ann. Thorac. Surg., October 1, 2008; 86(4): 1103 - 1103.
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