Related Experiment Videos
Morbidity and mortality in patients with usual interstitial pneumonia (UIP) pattern undergoing surgery for lung
Till Plönes1, Thomas Osei-Agyemang, Mirjam Elze
1Department of Thoracic Surgery, University Medical Center Freiburg, Hugstetter Strasse 55, 79106 Freiburg im Breisgau, Germany. Till.Ploenes@uniklinik-freiburg.de
Background:
Previous studies revealed that surgical lung biopsy in usual interstitial pneumonia (UIP) patients is accompanied with higher morbidity and mortality. The aim of this retrospective analysis was to assess morbidity and mortality of patients with suspected UIP undergoing surgical lung biopsy.
Methods:
We conducted a retrospective study of 45 patients with suspected UIP pattern undergoing surgical biopsy for diffuse pulmonary infiltrates in our department. Data concerning medical history, histology, and survival status were extracted from the medical database of the University Medical Center Freiburg.
Results:
UIP was diagnosed by experienced pneumo-pathologists according to the criteria of American Thoracic Society/European Respiratory Society (ATS/ERS) consensus classification. Due to adhesions the surgeon decided in two patients to perform wedge resection via open surgery. In 43 patients lung biopsy was performed via Video-assisted thoracoscopy (VATS). No intraoperative complications were observed. Postoperative complications consisted of bradyarrhythmia (n = 1), gastrointestinal bleeding (n = 1), bacterial pneumonia (n = 1), candida pneumonia (n = 1) and acute exacerbation (n = 1). There was no 30-day mortality, but one patient was lost in follow-up and therefore censored. The intraoperative placed thoracic drain was removed at the first postoperative day in most cases (mean day of removal 1.9, ±2.6). The mean length of hospital stay was 8.1 days (±6.8).
Conclusions:
We conclude that surgical biopsy can be safely performed in patients with suspected UIP.
Insights
Surgical lung biopsy for suspected usual interstitial pneumonia (UIP) is safe. This retrospective study found no 30-day mortality and manageable postoperative complications in patients undergoing biopsy for diffuse pulmonary infiltrates.
Area of Science:
- Pulmonology
- Thoracic Surgery
- Pathology
Background:
- Previous research indicates elevated morbidity and mortality associated with surgical lung biopsy in patients diagnosed with usual interstitial pneumonia (UIP).
- Suspected UIP cases often present with diffuse pulmonary infiltrates, necessitating accurate diagnosis.
Purpose of the Study:
- To evaluate the morbidity and mortality rates associated with surgical lung biopsy in patients suspected of having UIP.
- To assess the safety and feasibility of surgical lung biopsy in diagnosing diffuse pulmonary infiltrates.
Main Methods:
- A retrospective analysis of 45 patients with suspected UIP undergoing surgical biopsy for diffuse pulmonary infiltrates.
- Data extraction from the University Medical Center Freiburg database, including medical history, histology, and survival status.
- Diagnosis of UIP confirmed by experienced pneumo-pathologists based on ATS/ERS criteria.
Main Results:
- No intraoperative complications were recorded during the surgical procedures.
- Postoperative complications included bradyarrhythmia, gastrointestinal bleeding, bacterial pneumonia, fungal pneumonia, and acute exacerbation, each occurring in one patient.
- There was no 30-day mortality; one patient was lost to follow-up. Mean thoracic drain removal was on postoperative day 1.9, with an average hospital stay of 8.1 days.
Conclusions:
- Surgical lung biopsy can be performed safely in patients with suspected usual interstitial pneumonia.
- Video-assisted thoracoscopic surgery (VATS) is a viable approach for lung biopsy in this patient group.
- The procedure demonstrated acceptable complication rates and no short-term mortality.