title: Videothoracoscopic lung biopsy in the diagnosis of interstitial lung disease.
abstract: OBJECTIVE
  Interstitial lung diseases (ILD) require lung biopsy for the diagnosis in more than 30% of patients. Open lung biopsy (OLB) was generally considered the most reliable method of biopsy and tissue diagnosis. This study tests the diagnostic accuracy and safety of the videothoracoscopic lung biopsy (VTLB) in the diagnosis of ILD.
  
  
  METHODS
  During the last 5 years, 58 patients were submitted to VTLB under general anesthesia. The mean age was 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 specimens were sent to the microbiology and pathology department for microbiological and histopathological diagnosis. One chest-tube (28F) was positioned and connected to a drainage-system and placed on suction.
  
  
  RESULTS
  The histopathological diagnosis was obtained for all patients and therefore the diagnostic accuracy of the procedure was 100%. No postoperative haemothorax occurred and only two patients experienced a prolonged air-leakage (3.4%). The median duration of the chest-drain was 3 days (range 1-7) and the median hospital stay was 4 days (range 2-7).
  
  
  CONCLUSIONS
  VTLB provides adequate specimen volume for histopathologic diagnosis and achieves a very high diagnostic accuracy (100% in our series). The postoperative morbidity and mortality rates are lower than those related to OLB. We conclude that VTLB is an effective and safe procedure in the diagnosis of ILD.
authors.affiliation: Department of Thoracic Surgery, S. Giovanni Battista Hospital, University of Torino, Italy.
authors.forename: O
authors.initials: O
authors.lastname: Rena
authors.forename: C
authors.initials: C
authors.lastname: Casadio
authors.forename: F
authors.initials: F
authors.lastname: Leo
authors.forename: R
authors.initials: R
authors.lastname: Giobbe
authors.forename: R
authors.initials: R
authors.lastname: Cianci
authors.forename: S
authors.initials: S
authors.lastname: Baldi
authors.forename: M
authors.initials: M
authors.lastname: Rapellino
authors.forename: G
authors.initials: G
authors.lastname: Maggi
mesh_terms: D000328:Adult; D000368:Aged; D001706:Biopsy / Q000379:methods*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007902:Length of Stay; D017563:Lung Diseases, Interstitial / Q000401:mortality / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012189:Retrospective Studies; D015996:Survival Rate; D020775:Thoracic Surgery, Video-Assisted