Diagnostic surgical lung biopsies for suspected interstitial lung diseases: a retrospective study

2.50
Hdl Handle:
http://hdl.handle.net/2336/73274
Title:
Diagnostic surgical lung biopsies for suspected interstitial lung diseases: a retrospective study
Authors:
Sigurdsson, Martin I; Isaksson, Helgi J; Gudmundsson, Gunnar; Gudbjartsson, Tomas
Citation:
Ann. Thorac. Surg. 2009, 88(1):227-32
Issue Date:
1-Jul-2009
Abstract:
BACKGROUND: Current guidelines for interstitial lung disease support a surgical biopsy for optimal diagnosis and treatment, yet only a minority of patients undergo such biopsy. Our objectives were to address the properties of a surgical lung biopsy for suspected interstitial lung disease, the diagnostic yield of the procedure, and whether it resulted in changes in diagnosis and treatment. METHODS: A retrospective nationwide study including 73 patients (mean age, 57.3 years; 58% males) who underwent a surgical lung biopsy for suspected interstitial disease in Iceland between 1986 and 2007 was conducted. Patient records and histologic specimens were reviewed. Before the surgical biopsy a transbronchial or computed tomography-guided biopsy had been performed in two thirds of the patients. RESULTS: The complication rate for surgical lung biopsy was 16%, and 30-day operative mortality was 2.7%, both significantly higher in patients with preoperative respiratory failure. After the procedure, a definite histopathologic diagnosis was obtained in 81% of the patients. Usual interstitial pneumonia was the most common diagnosis (31%). The clinical diagnosis was changed for 73% of the patients, and in 53% of the patients the biopsy resulted in changes in treatment. CONCLUSIONS: Surgical lung biopsy is a powerful tool for diagnosis of suspected interstitial lung disease. It results in a specific diagnosis for the majority of patients and changes in treatment for more than half. Operative morbidity and mortality are low but still significant, so patients should be carefully selected for the procedure, especially those with respiratory failure.
Description:
To access publisher full text version of this article. Please click on the hyperlink in Additional Links field
Additional Links:
http://dx.doi.org/10.1016/j.athoracsur.2009.04.002

Full metadata record

DC FieldValue Language
dc.contributor.authorSigurdsson, Martin I-
dc.contributor.authorIsaksson, Helgi J-
dc.contributor.authorGudmundsson, Gunnar-
dc.contributor.authorGudbjartsson, Tomas-
dc.date.accessioned2009-07-10T11:09:18Z-
dc.date.available2009-07-10T11:09:18Z-
dc.date.issued2009-07-01-
dc.date.submitted2009-07-10-
dc.identifier.citationAnn. Thorac. Surg. 2009, 88(1):227-32en
dc.identifier.issn1552-6259-
dc.identifier.pmid19559230-
dc.identifier.doi10.1016/j.athoracsur.2009.04.002-
dc.identifier.urihttp://hdl.handle.net/2336/73274-
dc.descriptionTo access publisher full text version of this article. Please click on the hyperlink in Additional Links fielden
dc.description.abstractBACKGROUND: Current guidelines for interstitial lung disease support a surgical biopsy for optimal diagnosis and treatment, yet only a minority of patients undergo such biopsy. Our objectives were to address the properties of a surgical lung biopsy for suspected interstitial lung disease, the diagnostic yield of the procedure, and whether it resulted in changes in diagnosis and treatment. METHODS: A retrospective nationwide study including 73 patients (mean age, 57.3 years; 58% males) who underwent a surgical lung biopsy for suspected interstitial disease in Iceland between 1986 and 2007 was conducted. Patient records and histologic specimens were reviewed. Before the surgical biopsy a transbronchial or computed tomography-guided biopsy had been performed in two thirds of the patients. RESULTS: The complication rate for surgical lung biopsy was 16%, and 30-day operative mortality was 2.7%, both significantly higher in patients with preoperative respiratory failure. After the procedure, a definite histopathologic diagnosis was obtained in 81% of the patients. Usual interstitial pneumonia was the most common diagnosis (31%). The clinical diagnosis was changed for 73% of the patients, and in 53% of the patients the biopsy resulted in changes in treatment. CONCLUSIONS: Surgical lung biopsy is a powerful tool for diagnosis of suspected interstitial lung disease. It results in a specific diagnosis for the majority of patients and changes in treatment for more than half. Operative morbidity and mortality are low but still significant, so patients should be carefully selected for the procedure, especially those with respiratory failure.en
dc.language.isoenen
dc.publisherElsevieren
dc.relation.urlhttp://dx.doi.org/10.1016/j.athoracsur.2009.04.002en
dc.subject.meshPubMed - in processen
dc.titleDiagnostic surgical lung biopsies for suspected interstitial lung diseases: a retrospective studyen
dc.typeArticleen
dc.contributor.departmentDepartment of Cardiothoracic Surgery, Landspitali University Hospital Reykjavik, Reykjavik, Iceland.en
dc.identifier.journalAnnals of thoracic surgeryen

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