Video Assisted Thoracoscopic Surgery (VATS) Lung biopsy for non-responsive patients of Interstitial Lung Disease (ILD)

Abstract

Objective: To study the results of VATS (Video Assisted Thoracoscopic Surgery) Lung Biopsy in Interstitial Lung Disease (ILD)
Study Design: Case series
Place and Duration of Study: Department of Thoracic Surgery, CMH Rawalpindi from Jan 2009 to Mar 2010
Patient and Methods: All those patients of ILD (Interstitial Lung Disease) were included who failed to improve after a period of observation including those on empiric therapy, all patients in which BAL (Bronchoalveolar Lavage) and TBLB (Transbronchial Lung biopsy) was inconclusive and all those patients fit to undergo thoracoscopic surgery. Patients excluded were elderly patients, those with systemic disorders frequently associated with ILD and those with known neoplasm likely to have lymphangitic dissemination. We used three thoracoscopic ports, all biopsies were sent for histopathology examination, single chest tube was placed in all cases and it was removed once the airleak ceased. All complications encountered were noted.
Results: Fourteen patients were registered during study period. Biopsy showed that 9 had ILD, and 5 did not have ILD. Only complication was a prolonged airleak for 2 days in 2 patients. No mortality was encountered.
Conclusion: Thoracoscopic surgical biopsy can be accomplished safely in most cases where there is a diagnostic dilema for interstitial lung disease.