Zaraca Francesco, Ebner Heinrich
Reparto di Chirurgia Vascolare e Toracica, Ospedale Centrale Bolzano.
Chir Ital. 2006 Sep-Oct;58(5):569-76.
Surgical lung biopsy is indicated in the diagnosis of idiopathic interstitial lung disease in more than 30% of patients. Our study analyses the technical evolution of the surgery during recent years in our department and the results of thoracoscopic lung biopsy. We retrospectively analysed 31 consecutive patients who underwent thoracoscopic lung biopsy from Jan. 1 2000 to Dec. 31 2004; 16 were male and 15 female with a mean age of 58.17 +/- 11.84 years. From September 1991 to December 1999 we performed another 40 lung biopsies. The SPSS software package was used to process the data. All patients but one underwent bronchial lavage and transbronchial biopsy preoperatively, without obtaining a correct diagnosis. Surgical biopsy findings were diagnostic in all patients. The conversion rate to thoracotomy was 20.7%. The mean operative time was 67.9 +/- 16.7 minutes and a mean number of 2.4 +/- 0.8 wedge lung biopsies were performed. The mean chest drain duration and hospital stay were 6.0 +/- 4.7 days and 7.9 +/- 4.7 days, respectively. The perioperative minor complication rate was 6.9% and the mortality rate 0%. Our results confirm that thoracoscopy has a diagnostic accuracy of 100% with low complication and mortality rates. These results compare well with those of open lung biopsy.
超过30%的特发性间质性肺疾病患者的诊断需要进行外科肺活检。我们的研究分析了近年来我院该手术的技术演变以及胸腔镜肺活检的结果。我们回顾性分析了2000年1月1日至2004年12月31日期间连续接受胸腔镜肺活检的31例患者;其中男性16例,女性15例,平均年龄58.17±11.84岁。1991年9月至1999年12月期间,我们还进行了另外40例肺活检。使用SPSS软件包处理数据。除1例患者外,所有患者术前均接受了支气管灌洗和经支气管活检,但均未获得正确诊断。手术活检结果对所有患者均具有诊断价值。开胸手术转化率为20.7%。平均手术时间为67.9±16.7分钟,平均进行2.4±0.8次楔形肺活检。胸腔引流平均持续时间和住院时间分别为6.0±4.7天和7.9±4.7天。围手术期轻微并发症发生率为6.9%,死亡率为0%。我们的结果证实,胸腔镜检查诊断准确率为100%,并发症和死亡率较低。这些结果与开胸肺活检的结果相比具有优势。