HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Walker, W. A. Articles by Watson, D. C. Search for Related Content PubMed PubMed Citation Articles by Walker, W. A. Articles by Watson, D. C.

The Journal of Thoracic and Cardiovascular Surgery, Vol 97, 534-540, Copyright © 1989 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association

ARTICLES

Does open lung biopsy affect treatment in patients with diffuse pulmonary infiltrates?

WA Walker, FH Cole Jr, A Khandekar, SS Mahfood and DC Watson
University of Tennessee Health Sciences Center, Memphis.

The decision to perform open lung biopsy in the evaluation of a diffuse pulmonary infiltrate is based on the probability that this examination will yield specific information that may lead to a change in treatment. The role of this procedure remains controversial and many clinicians are reluctant to allow this invasive procedure without assurances that results will lead to a change in therapy for a significant number. To evaluate the impact of open lung biopsy on diagnosis and treatment of diffuse pulmonary infiltrates, we conducted a retrospective review of 61 patients undergoing this procedure at three university-affiliated hospitals during a recent 7-year period. There were 37 men and 24 women; average age was 57 years. Biopsy yielded a specific diagnosis in 21 (34%) patients and a change in therapy in 33 (54%) patients. A complication developed in 11 (18%) patients, directly related to the biopsy procedure in six (10%). Eight patients died. The immune status in 22 (36%) patients was compromised. A specific diagnosis was obtained in 13 (59%) immunocompromised patients and a change in therapy occurred in 17 (77%) of these patients after biopsy. A specific diagnosis was obtained in only eight (21%) of the 39 noncompromised patients and therapy was changed in 16 (41%) patients in this group (p less than 0.02 compromised versus noncompromised). Morbidity and mortality were not significantly different between the two groups. A nonspecific diagnosis led to a change in therapy as frequently as a specific diagnosis in both compromised and noncompromised groups. Open lung biopsy in the patient with a diffuse pulmonary infiltrate is an accurate diagnostic tool and frequently leads to a change in patient treatment. The procedure can be performed with acceptable morbidity and mortality in immunocompromised and noncompromised patients.

This article has been cited by other articles:

				G. F. Coutinho, R. Pancas, E. Magalhaes, J. E. Bernardo, L. Eugenio, and M. J. Antunes Diagnostic value of surgical lung biopsy: comparison with clinical and radiological diagnosis Eur. J. Cardiothorac. Surg., May 1, 2008; 33(5): 781 - 785. [Abstract] [Full Text] [PDF]

				M. E. Halkos, A. A. Gal, F. Kerendi, D. L. Miller, and J. I. Miller Jr Role of Thoracic Surgeons in the Diagnosis of Idiopathic Interstitial Lung Disease Ann. Thorac. Surg., June 1, 2005; 79(6): 2172 - 2179. [Abstract] [Full Text] [PDF]

				Y.-C. Lee, C.-T. Wu, H.-H. Hsu, P.-M. Huang, and Y.-L. Chang Surgical lung biopsy for diffuse pulmonary disease: Experience of 196 patients J. Thorac. Cardiovasc. Surg., May 1, 2005; 129(5): 984 - 990. [Abstract] [Full Text] [PDF]

				M. Yamaguchi, I. Yoshino, R. Suemitsu, A. Osoegawa, T. Kameyama, T. Tagawa, S. Fukuyama, and Y. Maehara Elective Video-Assisted Thoracoscopic Lung Biopsy for Interstitial Lung Disease Asian Cardiovasc Thorac Ann, March 1, 2004; 12(1): 65 - 68. [Abstract] [Full Text] [PDF]

				M.-L. Chuang, I-F. Lin, Y.-H. Tsai, J. R. E. Vintch, and L.-C. Pang The Utility of Open Lung Biopsy in Patients With Diffuse Pulmonary Infiltrates as Related to Respiratory Distress, Its Impact on Decision Making by Urgent Intervention, and the Diagnostic Accuracy Based on the Biopsy Location J Intensive Care Med, January 1, 2003; 18(1): 21 - 28. [Abstract] [PDF]

				R. A. Qureshi, T. A. Ahmed, A. D. Grayson, A. S. Soorae, M. J. Drakeley, and R. D. Page Does lung biopsy help patients with interstitial lung disease? Eur. J. Cardiothorac. Surg., April 1, 2002; 21(4): 621 - 626. [Abstract] [Full Text] [PDF]

				R. T. Temes, N. E. Joste, N. L. Allen, R. E. Crowell, H. A. Dox, and J. A. Wernly The lingula is an appropriate site for lung biopsy Ann. Thorac. Surg., April 1, 2000; 69(4): 1016 - 1018. [Abstract] [Full Text] [PDF]

				R. T. Temes, N. E. Joste, C. R. Qualls, N. L. Allen, R. E. Crowell, H. A. Dox, and J. A. Wernly LUNG BIOPSY: IS IT NECESSARY? J. Thorac. Cardiovasc. Surg., December 1, 1999; 118(6): 1097 - 1100. [Abstract] [Full Text] [PDF]

				A. Flabouris and J. Myburgh The Utility of Open Lung Biopsy in Patients Requiring Mechanical Ventilation Chest, March 1, 1999; 115(3): 811 - 817. [Abstract] [Full Text] [PDF]

				R. Zegdi, J. Azorin, B. Tremblay, M. D. Destable, P. S. Lajos, and D. Valeyre Videothoracoscopic lung biopsy in diffuse infiltrative lung diseases: a 5-year surgical experience Ann. Thorac. Surg., October 1, 1998; 66(4): 1170 - 1173. [Abstract] [Full Text] [PDF]

				M. R. Kramer, N. Berkman MBBCh, B. Mintz, S. Godfrey, M. Saute, and G. Amir MBBCH The Role of Open Lung Biopsy in the Management and Outcome of Patients With Diffuse Lung Disease Ann. Thorac. Surg., January 1, 1998; 65(1): 198 - 202. [Abstract] [Full Text] [PDF]

				L. Davies, S. Dolgin, and M. Kattan Morbidity and Mortality of Open Lung Biopsy in Children Pediatrics, May 1, 1997; 99(5): 660 - 664. [Abstract] [Full Text] [PDF]