An Ideal Choice in the Diagnosis of Interstitial Lung Diseases: Video- Assisted Thoracoscopic Surgery

Abstract

Aim: Interstitial lung diseases are a heterogeneous group of diseases with a known or unknown etiology affecting the interstitium of the lung. In this study, our experience in the lung biopsy performed by video-assisted thoracoscopic surgery and open lung biopsy for interstitial lung diseases is discussed. Material and Method: In this study, we reviewed 31 patients with a clinical diagnosis of interstitial lung disease who underwent open or thoracoscopic lung biopsy between the years of 2004 and 2010. The cases were examined retrospectively for the age, sex, radiological appearance, operative time, chest tube duration, postoperative hospital stay and the complications. Thoracotomy was performed to 19 of the patients (61.30%) while twelve patients (38.70%) underwent video-assisted thoracoscopic surgery. Result: Fourteen of the cases (45.16%) were male while 17 patients were female (58.06%) with a mean age of 40.83 +/- 15.537 (18-69). Nonspecific interstitial fibrosis constituted the most of the certain diagnoses (29.27%). Operative time, chest tube duration and postoperative hospital stay were significantly shorter in video-assisted thoracoscopic surgery group (p values were 0.018, 0.001 and 0.011 respectively). The overall morbidity rate was 12.90% and there was no mortality. Discussion: In spite of recent advances in clinical diagnostic techniques, lung biopsy is the gold standard for the diagnosis of interstitial lung disease. In our opinion, video-assisted thoracoscopic surgery should be the first choice in the diagnosis of interstitial lung diseases, since these patients can be discharged early as a result of shorter chest tube duration and hospital length of stay.