Diagnostic value of video-assisted thoracoscopic lung biopsies in interstitial lung disease

Objective To evaluate the safety and diagnostic yield of video-assisted thoracoscopic lung biopsies (VTLB) in the diffuse interstitial lung disease (ILD). Methods The clinical radiological and pathological data of 26 cases with ILD of non-specific diagnosis performed VTLB in Nanjing Drum Tower Hospiral during October 2010 to December 2016 were retrospectively analyzed.Outcomes included clinical symptoms, high-resolution computed tomography images, comparison between pre-operative and post-operative diagnosis, the site and number of biopsies and complications. Results Among 26 cases, definitive clinical diagnosis was reached in 24 cases (92.31%) after combination of pathological, clinical and radiological manifestations and 2 cases (7.69%) could not achieved diagnosis even after the VTLB lung biopsies.Sixteen cases (61.54%) had a change in their treatment following the results of VTLB lung biopsies.The number of biopsies taken was ranged from one to three and three cases (11.54%) had one biopsy, 15 cases (57.69%) had two biopsies and 8 cases (30.77%) had three biopsies.The most common site of operation was right lower lobe.Nine cases (34.62%) had complications after VTLB, and pulmonary infection and pneumothorax were the most common complications.There was no death case and acute exacerbation of ILD. Conclusions The VTLB can provide a diagnosis for most of the ILD patients.The procedure leads to a change in treatment in almost half of all patients.The morbidity and mortality related with VTLB are low.It has been shown to be a relatively safe and effective procedure and thus, should be performed in all patients with suspected ILD. Key words: Lung disease, interstitial; Thoracoscopy; Tomography, X-ray computed; Diagnosis