Mohammed Khalil1, Michael Cowen2, Mubarak Chaudhry2, Mahmoud Loubani2. 1. Department of Cardiothoracic Surgery, Castle Hill Hospital, Cottingham, UK wesam@doctor.com. 2. Department of Cardiothoracic Surgery, Castle Hill Hospital, Cottingham, UK.
Abstract
BACKGROUND: There is a belief that in patients with suspected interstitial lung disease, multiple biopsies from different lobes are more likely to result in a diagnosis. We compared the results of single biopsies with those of multiple biopsies in terms of positive yield of histological diagnoses and the patients' postoperative outcomes. METHODS: Data of 115 patients who underwent video-assisted thoracoscopic lung biopsy, between 2009 and 2015, for suspected interstitial lung disease were analyzed retrospectively and grouped according to single or multiple lung biopsies. High-resolution computed tomography of the chest was reviewed prior to the procedure, and the most appropriate areas for sampling were chosen. Data analysis was carried out with the Mann-Whitney U test, using MedCalc version 16.1 statistical software. RESULTS: Of the 115 patients, 67 had a single biopsy and 48 had more than one biopsy. A histological diagnosis was arrived at in all cases. The duration of chest drainage (p = 0.033) and postoperative hospital stay (p = 0.012) were longer in the multiple-biopsies group. CONCLUSION: A single lung biopsy is sufficient to arrive at a diagnosis of interstitial lung disease when the sampling site is guided by high-resolution computed tomography and a multidisciplinary approach. Multiple biopsies are less cost-effective, offer no added advantage in terms of diagnostic yield, and are associated with more morbidities and a longer hospital stay.
BACKGROUND: There is a belief that in patients with suspected interstitial lung disease, multiple biopsies from different lobes are more likely to result in a diagnosis. We compared the results of single biopsies with those of multiple biopsies in terms of positive yield of histological diagnoses and the patients' postoperative outcomes. METHODS: Data of 115 patients who underwent video-assisted thoracoscopic lung biopsy, between 2009 and 2015, for suspected interstitial lung disease were analyzed retrospectively and grouped according to single or multiple lung biopsies. High-resolution computed tomography of the chest was reviewed prior to the procedure, and the most appropriate areas for sampling were chosen. Data analysis was carried out with the Mann-Whitney U test, using MedCalc version 16.1 statistical software. RESULTS: Of the 115 patients, 67 had a single biopsy and 48 had more than one biopsy. A histological diagnosis was arrived at in all cases. The duration of chest drainage (p = 0.033) and postoperative hospital stay (p = 0.012) were longer in the multiple-biopsies group. CONCLUSION: A single lung biopsy is sufficient to arrive at a diagnosis of interstitial lung disease when the sampling site is guided by high-resolution computed tomography and a multidisciplinary approach. Multiple biopsies are less cost-effective, offer no added advantage in terms of diagnostic yield, and are associated with more morbidities and a longer hospital stay.
Authors: Ganesh Raghu; Martine Remy-Jardin; Christopher J Ryerson; Jeffrey L Myers; Michael Kreuter; Martina Vasakova; Elena Bargagli; Jonathan H Chung; Bridget F Collins; Elisabeth Bendstrup; Hassan A Chami; Abigail T Chua; Tamera J Corte; Jean-Charles Dalphin; Sonye K Danoff; Javier Diaz-Mendoza; Abhijit Duggal; Ryoko Egashira; Thomas Ewing; Mridu Gulati; Yoshikazu Inoue; Alex R Jenkins; Kerri A Johannson; Takeshi Johkoh; Maximiliano Tamae-Kakazu; Masanori Kitaichi; Shandra L Knight; Dirk Koschel; David J Lederer; Yolanda Mageto; Lisa A Maier; Carlos Matiz; Ferran Morell; Andrew G Nicholson; Setu Patolia; Carlos A Pereira; Elisabetta A Renzoni; Margaret L Salisbury; Moises Selman; Simon L F Walsh; Wim A Wuyts; Kevin C Wilson Journal: Am J Respir Crit Care Med Date: 2020-08-01 Impact factor: 30.528