Legrand M, Andreassian B, Chemouilli E
Nouv Presse Med. 1978 Dec 30;7(47):4291-3.
This series of surgical lung biopsies performed for diffuse lung disease indicates the excellent tolerance of the procedure and the high diagnostic rate. It is indicated above all in the presence of bilateral reticulo-nodular radiological appearances, suggestive of focal lesions not identified by the usual means. The surgical procedure was felt to be justified on the one hand because of the time gained in reaching a precise diagnosis whilst the results of usual laboratory investigations, even the most sophisticated, remain uncertain, and secondly in view of the discovery by the method of malignant lesions which are still curable and which it would have been impossible to identify otherwise, except by awaiting the development of more accessible lesions. Whilst percutaneous needle biopsy found favour amongst many, it would now seem to have been virtually abandoned, particular in France, in view of its risks and it's poor diagnostic rate. By contrast, open surgical biopsy provides in all cases not only lung but also pleural and mediastinal tissue. Its risks are confined to those of any surgical procedure under general anaesthesia, but appear to be sufficiently slight (mortality of 0,5 to 2%) that the technique may be used successfully in intensive care units to obtain a diagnosis in cases of certain types of respiratory distress.
这一系列为弥漫性肺部疾病进行的外科肺活检表明该手术耐受性良好且诊断率高。它尤其适用于存在双侧网状结节状影像学表现、提示常规方法未发现的局灶性病变的情况。一方面，手术操作被认为是合理的，因为在常规实验室检查（即使是最复杂的检查）结果仍不确定的情况下，通过手术能更快获得准确诊断；另一方面，该方法能发现仍可治愈的恶性病变，而若非如此，除了等待更易发现的病变出现，否则无法识别这些病变。虽然经皮针吸活检受到许多人的青睐，但鉴于其风险和较低的诊断率，现在似乎已基本被摒弃，在法国尤其如此。相比之下，开放性外科活检在所有病例中不仅能获取肺组织，还能获取胸膜和纵隔组织。其风险仅限于全身麻醉下任何外科手术的风险，但似乎足够轻微（死亡率为0.5%至2%），以至于该技术可在重症监护病房成功用于对某些类型呼吸窘迫病例进行诊断。
