title: Single versus multiple lung biopsies for suspected interstitial lung disease.
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.
  
  
  CONCLUSIONS
  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.affiliation: Department of Cardiothoracic Surgery, Castle Hill Hospital, Cottingham, UK wesam@doctor.com.
authors.forename: Mohammed
authors.initials: M
authors.lastname: Khalil
authors.affiliation: Department of Cardiothoracic Surgery, Castle Hill Hospital, Cottingham, UK.
authors.forename: Michael
authors.initials: M
authors.lastname: Cowen
authors.affiliation: Department of Cardiothoracic Surgery, Castle Hill Hospital, Cottingham, UK.
authors.forename: Mubarak
authors.initials: M
authors.lastname: Chaudhry
authors.affiliation: Department of Cardiothoracic Surgery, Castle Hill Hospital, Cottingham, UK.
authors.forename: Mahmoud
authors.initials: M
authors.lastname: Loubani
mesh_terms: D001706:Biopsy / Q000009:adverse effects / Q000379:methods*; D015505:Chest Tubes; D004322:Drainage / Q000295:instrumentation; D006801:Humans; D007902:Length of Stay; D017563:Lung Diseases, Interstitial / Q000473:pathology* / Q000628:therapy; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012307:Risk Factors; D020775:Thoracic Surgery, Video-Assisted / Q000009:adverse effects; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
keywords: Biopsy; Diagnosis; Lung diseases; Pulmonary fibrosis; Thoracoscopy; differential; interstitial