Videothoracoscopic lung biopsy (VTLB) as the method of choice for diagnosis of diffuse lung diseases (DLD)
V. G. Pischik, M. A. Atiukov, T. A. Stepanenko, O. B. Ilyina, N. E. Okuneva, T. A. Fedorova, P. K. Yablonsky (St-Petersburg, Russia)
Source: Annual Congress 2002 - Pleural disease
Session: Pleural disease
Session type: Thematic Poster Session
Number: 537
Disease area: Interstitial lung diseases
Abstract Patients with DLD require a lung biopsy for diagnosis in more than 30% of cases. From 1997 to 2001 53 patients underwent VTLB. 21 males and 32 females, mean age 47,3 years. All of them had one of the next signs: pulmonary dissemination or diffuse infiltrate, or/and progressive dyspnea. Transbronchial lung biopsy gave no information about nosological diagnosis. VTLB were performed with ordinary stapler, inserted througt mininthoracotomy without ribspreading. One chest-tube was positioned and suction system was used. We had no mortality. Mean operation time was 36,3±]14,1 min, mean time for the chest tube removed – 1,53 ±] 1,22 days. All but one patient had no serious complications. 51-years old female with giant cutaneous cavernous haemangioma had postoperative coagulopathic bleeding due to platelet consumption (Kasabach-Merritt syndrome). It requaired thoracotomy and addition of plasma transfusion. After pathological examination we confirmed definitial diagnosis in 100% of cases: sarcoidosis 11, tuberculosis 11, idiopathic pulmonary fibrosis 9, diffuse lung carcinoma 5 cases, pulmonary vasculitis - 4, silicosis – 3, histiocytosis X – 3, pulmonary fibrosis with the collagen-vascular disorders – 2, alveolar proteinosis – 1, bronchiolitis obliterance – 1, exogenous allergic alveolitis – 1, leiomyomatosis – 1, tuberous sclerosis – 1. Those different diseases had very insignificant difference with symptoms, and this is a reason for using lung biopsy. VTLB provides a very high diagnostic accuracy (100% in our series) in DLD of unknown origin. Using of small additional incision allows to reduce the cost of procedures.
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V. G. Pischik, M. A. Atiukov, T. A. Stepanenko, O. B. Ilyina, N. E. Okuneva, T. A. Fedorova, P. K. Yablonsky (St-Petersburg, Russia). Videothoracoscopic lung biopsy (VTLB) as the method of choice for diagnosis of diffuse lung diseases (DLD). Eur Respir J 2002; 20: Suppl. 38, 537
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