Open pulmonary biopsy. Nineteen-year experience with 416 consecutive operations.

Area of Science:

• Pulmonology
• Thoracic Surgery
• Diagnostic Procedures

Background:

• Diffuse lung diseases of unknown etiology present diagnostic challenges.
• Accurate diagnosis is crucial for appropriate patient management and treatment.
• Open pulmonary biopsy is a potential diagnostic tool.

Purpose of the Study:

• To report the experience with open pulmonary biopsy through limited thoracotomies.
• To define the spectrum of diagnoses, complications, and outcomes.
• To evaluate its role in diagnosing diffuse lung disease.

Main Methods:

• Retrospective review of 416 open pulmonary biopsies performed via limited thoracotomies.
• Analysis of case selection, operative techniques, diagnostic yield, and complications.
• Comparison with alternative diagnostic methods.

Main Results:

• Sufficient tissue for diagnosis was obtained in all 416 cases.
• Common diagnoses included occupational lung disease (25%), nonspecific lung disease (29%), and neoplastic disease (19%).
• The most frequent complication was pneumothorax (23%), usually minor, with only 6% requiring chest tube placement. Pleural effusion was also common (25%) but minor. Overall mortality was 4.5%, with only 0.4% procedure-related deaths.

Conclusions:

• Open pulmonary biopsy via limited thoracotomy is a reliable and safe procedure for diagnosing diffuse lung disease.
• It provides a high diagnostic yield with acceptable morbidity and mortality.
• It remains a preferred diagnostic method for diffuse lung disease of undetermined origin.