Assessing the Safety and Clinical Impact of Thoracoscopic Lung Biopsy in Patients with Interstitial Lung Disease
Journal Title: Journal of Clinical and Diagnostic Research - Year 2017, Vol 11, Issue 3
Abstract
Introduction: The clinical relevance of surgical lung biopsy in Interstitial Lung Disease (ILD) is supported in the literature. Yet most reports reflect institutional or personal bias. Aim: To evaluate the validity of radiologic diagnosis and clinical impact of lung biopsy to help clarify which patient benefit most from biopsy. Materials and Methods: We performed a retrospective analysis of a prospectively managed database. All patients who had a surgical lung biopsy for ILD within a period of four year (2009 to 2013) were included. Data included patient demographics, peri-operative variables and outcomes. Preoperative Computed Tomography (CT) imaging was reviewed by a thoracic radiologist blinded to the original report and pathologic information. Results: A total of 47 patients were included. Lung tissue was obtained via a thoracoscopic approach in all but two that had mini-thoracotomy. Mean operating time was 51.1 minutes (18- 123), median hospital stay was two days (1-18). Most (87.2%) of the patients were discharged within 72 hours. Thirty day mortality for elective surgery was 4.5% (2/44). Post-operative complications occurred in about one third of the patients. Complications in elective procedures included pneumothorax (10.4%), re-intubation (5.4%) and prolonged intubation (2.7%). Full concordance of radiographic diagnosis with the final diagnosis was significantly higher when reviewed by a cardiothoracic radiologist (60.5% vs. 21.3%). The preoperative clinical diagnosis was fully concordant with the final diagnosis in only 28.2% of cases. In 13.0% of patients the preoperative diagnosis was incorrect. Malignancy was the final diagnosis in two (4.3%) patients. In 51.1% of the patients, results of the biopsy did alter therapy. Conclusion: Diagnosis of specific ILD by a cardiothoracic radiologist is more specific and accurate and will probably lead to more appropriate therapy. Elective thoracoscopic surgical lung biopsy is a safe procedure, leads to a more accurate diagnosis of ILD and impacts therapy
Authors and Affiliations
Scott Lieberman, James Benjamin Gleason, Mohamed Iyoob Mohamed Ilyas, Felipe Martinez, Jinesh P Mehta, Edward B Savage
Keywords
Related Articles
- EP ID EP335717
- DOI 10.7860/JCDR/2017/20281.9626
- Views 99
- Downloads 0
Linezolid Resistant Enterococcus: An Important Emerging Pathogen Isolated from a Non Healing Ulcer of a Diabetic Foot Patient
Letter to Editor
Awareness and Referral Patterns of Diabetic Retinopathy: A Hospital Based Study
Introduction: Diabetic Retinopathy (DR) has emerged as an important cause of ocular morbidity and blindness in past 20 years. About one fifth of known diabetics are projected to have DR in their lifetime. Thus awareness...
Evaluation of Dyslipidaemia and Echocardiographic Markers of Myocardial Contractility in Smokers with Ischaemic Heart Disease
Introduction: Cigarette smoking is responsible for dyslipidaemia and haemodynamic disturbances. Aim: The present study was conducted to evaluate the parameters of dyslipidaemia and left ventricular ejection fraction in s...
Receiver Operator Characteristic Analysis of Biomarkers Evaluation in Diagnostic Research
ABSTRACT Receiver Operator Characteristic (ROC) analysis is the choice of method in evaluation of biomarkers in bioinformatics research. However, there is no single method and also no single accuracy index in evaluating...
Ethics and Attitude- From Seed to Sapling: Perspective from India
ABSTRACT Ethics and attitude are important attributes in one’s life. These values have to be taught from the childhood in schools and should be reinforced during the adolescent phase in college life. Methods to impart th...