Open lung biopsy performed in idiopathic pulmonary fibrosis is a safe procedure

Idiopathic pulmonary fibrosis (IPF) is an interstitial lung disease with a fatal prognosis. The diagnosis is made on the basis of high-resolution computed tomography and histological examination in selected cases.

To determine the risk of complications of open lung biopsy performed in patients with IPF.

We performed a retrospective analysis of 51 patients who underwent diagnostic excision of pulmonary parenchyma due to IPF in the period 1995-2014. We assessed the complication rate, length of drainage, postoperative period and 30-day mortality. We compared the results of treatment in the groups of patients operated on with thoracotomy and videothoracoscopy.

The mean age of patients was 58 (47% female, 53% male) forced vital capacity (FVC) was 81%, forced expiratory volume in 1 s (FEV₁) was 80% and body mass index (BMI) was 27 kg/m². Thoracotomies (lateral, muscle sparing or anterior) were performed in 20 patients between 1995 and 2012 and videothoracoscopy in 31 patients operated on in the years 2009-2014. Patients in study groups did not differ considering age (p = 0.40), gender (p = 0.81), FVC (p = 0.08), FEV₁ (p = 0.13) or BMI (p = 0.75). Postoperative complications occurred in 3.9% of patients (atrial arrhythmia 1.9% and recurrent pneumothorax 1.9%) with equal incidence in both study groups (p = 0.75). Median stay after thoracotomy was 4 days while after videothoracoscopy it was 3 days (p = 0.04).

Open lung biopsy performed on patients with IPF is a safe procedure. Open lung biopsy performed through thoracotomy could be as safe as through VATS, however is characterized by longer postoperative stay.