Video-assisted thoracoscopic lung biopsy in the diagnosis of interstitial lung disease: a prospective, multi-center study in 224 patients

Arch Bronconeumol. 2012 Mar;48(3):81-5. doi: 10.1016/j.arbres.2011.11.002. Epub 2012 Jan 13.
[Article in English, Spanish]


Objectives: To evaluate whether the location and number of lung biopsies obtained by video-assisted thoracoscopy (VAT) influence the diagnosis of diffuse interstitial lung disease (ILD). To assess the applicability of an Ambulatory Surgery Program (ASP).

Methods: Prospective, multicenter study of VAT lung biopsies due to suspected ILD from January 2007 to December 2009, including 224 patients from 13 Spanish centers (mean age 57.1 years; 52.6% females). Data were prospectively collected in every institution and sent to the coordination center for analysis.

Results: The most affected areas in high resolution chest CT were the lower lobes (55%). Bronchoscopy was performed in 84% and transbronchial biopsy in 49.1%. In 179 cases (79.9%), more than one biopsy was performed, with a diagnostic agreement of 97.2%. A definitive histopathologic diagnosis was obtained in 195 patients (87%). Idiopathic pulmonary fibrosis was the most frequent diagnosis (26%). There were no statistically significant factors that could predict a greater diagnostic yield (neither anatomical location nor number of biopsies). Seventy patients (31.3%) were included in an ASP. After discharge, there were complications in 12 patients (5.4%), similar between patients admitted postoperatively (9/154: 5.8%) and those included in an ASP (3/70: 4.3%).

Conclusions: Anatomical location and number of lung biopsy specimens did not seem to influence the diagnosis. The patients included in an ASP had a complication rate comparable to that of the hospitalized, so this procedure can be included in a surgical outpatient program. Lung biopsy obtained by VAT is a powerful and safe tool for diagnosis of suspected ILD, resulting in a definitive diagnosis for the majority of patients with a low morbidity rate.

Publication types

  • Clinical Trial
  • Multicenter Study

MeSH terms

  • Adult
  • Aged
  • Ambulatory Surgical Procedures
  • Biopsy / adverse effects
  • Biopsy / methods*
  • Bronchoscopy
  • Chest Tubes
  • Feasibility Studies
  • Female
  • Humans
  • Lung Diseases, Interstitial / classification
  • Lung Diseases, Interstitial / diagnosis*
  • Lung Diseases, Interstitial / diagnostic imaging
  • Lung Diseases, Interstitial / pathology
  • Lung Diseases, Interstitial / surgery
  • Male
  • Middle Aged
  • Prospective Studies
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Thoracic Surgery, Video-Assisted / adverse effects
  • Thoracic Surgery, Video-Assisted / methods*
  • Tomography, X-Ray Computed