Abstract
Introduction: Recent advances in minimal invasive techniques and instrumentation have expanded the role of medical thoracoscopy.The introduction of an endoscopic stapling device has encouraged thoracoscopic lung biopsy.
Aims and objectives: Evaluation of the quality of biopsy,the diagnostic efficacy and yield in high risk patients (pts) who underwent medical thoracoscopic lung biopsy (MTLB) for the evaluation of peripheral mass or diffuse interstitial lung disease using a stapler device under regional anaesthesia and neuroleptic analgesia.
Materials and methods: During 2002–2011, 30 high risk pts (75% severe respiratory failure,40% renal failure,33% ischemic stroke)underwent MTLB. Biopsy samples were obtained by a stapler device. Midazolam and fentanyl were used for anaesthesia and intercostal block was performed in all patients with ropivacain
Results: Pts were 18 males and 12 females (mean age 68.9 years,range 28-75 years). Mean duration of the procedure was 30 min (15–35 min). No intra-/post- operative deaths nor major complications were recorded.Successful analgesia was achieved in all pts.Biopsy specimens from the stapler device had mean dimensions:3.2x1.7x0.9cm (mean volume: 3.61ccm).All lung biopsies were conclusive and diagnostic.Malignancy was diagnosed in 17/30 pts and nonmalignant conditions in 13/30 (43% interstitial lung diseases,50% interstitial pneumonia,7%infarct).No complications were recorded.
Conclusions: Stapler tissue specimens received by MTLB have a high diagnostic accuracy in pts with peripheral tumours and diffuse interstitial lung disease.MTLB by stapler device is a pioneer method assuring superior quality of biopsy and can be applied in high risk pts without complications.
- © 2011 ERS