Department of Thoracic Surgery, University Medical Center Freiburg, Hugstetter Strasse 55, 79106 Freiburg im Breisgau, Germany.
Respir Med. 2013 Apr;107(4):629-32. doi: 10.1016/j.rmed.2012.11.020. Epub 2013 Jan 20.
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.
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.
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).
We conclude that surgical biopsy can be safely performed in patients with suspected UIP.
先前的研究表明,在寻常型间质性肺炎(UIP)患者中进行外科肺活检伴随着更高的发病率和死亡率。本回顾性分析的目的是评估疑似 UIP 行外科肺活检患者的发病率和死亡率。
我们对我院 45 例因弥漫性肺浸润而接受外科活检的疑似 UIP 患者进行了回顾性研究。从弗莱堡大学医学中心的医学数据库中提取了有关病史、组织学和生存状况的数据。
根据美国胸科学会/欧洲呼吸学会(ATS/ERS)共识分类的标准,经验丰富的病理学家诊断为 UIP。由于粘连,外科医生决定在 2 名患者中通过开胸手术行楔形切除术。在 43 名患者中,通过电视辅助胸腔镜(VATS)进行了肺活检。术中未观察到并发症。术后并发症包括心动过缓(n=1)、胃肠道出血(n=1)、细菌性肺炎(n=1)、念珠菌肺炎(n=1)和急性加重(n=1)。无 30 天死亡率,但有 1 例患者失访并被删失。大多数情况下,术中放置的胸腔引流管在术后第 1 天(平均拔除日 1.9,±2.6)被拔除。平均住院时间为 8.1 天(±6.8)。
我们的结论是,外科活检可安全用于疑似 UIP 的患者。