The effect of lung biopsy on lung function in diffuse lung disease

Abstract

The aim of this study was to investigate the effect on lung function of lung biopsy used in the diagnosis of diffuse lung disease carried out by an open procedure or by video‐assisted thoracoscopy. One hundred and sixteen patients with diffuse lung disease who attended the Royal Brompton Hospital were studied retrospectively. Thirty five patients underwent open lung biopsy, and 33 video‐assisted thoracoscopic biopsy and 48 had their diagnosis made without biopsy. All patients underwent lung function tests before and after surgery, or at an interval of 3–6 months in those who did not undergo biopsy. No significant differences were found in changes in lung function between those who had and had not undergone biopsy, and the proportions of patients whose lung function improved or deteriorated were similar. Lung biopsy by an open procedure or by video‐assisted thoracoscopy did not differ in its effects on lung function. The results for older patients, those with severe disease and those with fibrosing alveolitis were the same as for the whole group. Open lung biopsy for the diagnosis of diffuse lung disease does not deleteriously affect lung function whether carried out by an open or a minimally invasive procedure.

Mortality and risk factors for surgical lung biopsy in patients with idiopathic interstitial pneumonia

“…The risk of surgical lung biopsy for interstitial lung disease has been regarded as being low, while previous reports on the 30-day mortality rate after surgical lung biopsy have varied from 2.7 to 12.0% [7,9,11,12,[15][16][17]. Lettieri et al reported 30-day and 90-day mortality rates of 4.8 and 6.0%, respectively, among 83 patients with IIP and described that the only predictors of perioperative mortality were the need for mechanical ventilation and an immunosuppressed state at the time of biopsy [12].…”

Interstitial lung disease guideline

“…Postoperative pain (early and late) and persistent air leak are the commonest complications. A retrospective study of 88 patients with diffuse lung disease showed that surgical biopsy had no detrimental effect on lung function 2–6 months after the procedure compared with 48 non-biopsied patients 253. Recently, a study reported that 10 of 60 patients in whom a diagnosis of UIP was made following surgical biopsy had died within 30 days of operation 254.…”

Diagnostic Invasive Procedures in Diffuse Infiltrative Lung Diseases

“…However, it is not feasible in the presence of severe pleural adhesions or a fused pleural space, or in patients that are not able to tolerate one-lung ventilation. It seems that open lung biopsy for the diagnosis of diffuse lung disease does not deleteriously affect lung function whether carried out by an open or a minimally invasive procedure [66]. …”