Original articleGeneral thoracicComplications of Video-Assisted Thoracoscopic Lung Biopsy in Patients with Interstitial Lung Disease
Section snippets
Study Design
We performed a retrospective cohort study of consecutive outpatients who underwent VATS lung biopsy for diagnosis of an ILD between January of 1998 and July of 2004 at The Hospital of the University of Pennsylvania in Philadelphia, Pennsylvania. During this study period, no open lung biopsy procedures were performed on outpatients referred for diagnosis of an ILD. The study protocol was reviewed and approved by the Institutional Review Board at the University of Pennsylvania in December 2004
Study Population
The cohort of 68 patients included in this report is described in Table 1. The subjects had an average age of 58 years (range, 38 to 84 years), 56% were women, and 73% were white. Fifty percent were former smokers. Most had mild-to-moderate pulmonary functional impairment as determined by pulmonary function testing. Thirteen patients (19%) were taking oral corticosteroids, another 13 (19%) were taking inhaled corticosteroids at the time of biopsy, and 1 patient was taking methotrexate
Comment
Our study demonstrates a 60-day mortality rate of 4.4% and a morbidity rate of 19% in 68 consecutive outpatients undergoing VATS lung biopsy for diagnosis of an ILD at one university hospital. We find further that preoperative oxygen use, lower TLC%, and a PASP greater than 40 were statistically associated with the development of morbidity. Elevated pulmonary artery pressure was present in two thirds of those who died, but the lack of this having been measured preoperatively in all patients
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