title: Needlescopic lung biopsy for interstitial lung disease and indeterminate pulmonary nodules: a report on 65 cases.
abstract: 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.
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, College of Medicine, Korea University Guro Hospital, Seoul, Republic of Korea.
authors.forename: Hyun Koo
authors.initials: HK
authors.lastname: Kim
authors.forename: Won-Min
authors.initials: WM
authors.lastname: Jo
authors.forename: Jae Ho
authors.initials: JH
authors.lastname: Jung
authors.forename: Won Jae
authors.initials: WJ
authors.lastname: Chung
authors.forename: Jae Hoon
authors.initials: JH
authors.lastname: Shim
authors.forename: Young Ho
authors.initials: YH
authors.lastname: Choi
authors.forename: In Sung
authors.initials: IS
authors.lastname: Lee
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001707:Biopsy, Needle / Q000379:methods*; D015331:Cohort Studies; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D017563:Lung Diseases, Interstitial / Q000473:pathology* / Q000601:surgery; D008175:Lung Neoplasms / Q000473:pathology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D009367:Neoplasm Staging; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D003074:Solitary Pulmonary Nodule / Q000473:pathology* / Q000601:surgery; D013906:Thoracoscopy / Q000379:methods*