Perioperative risk factors in surgical lung biopsy for the diagnosis of interstitial lung disease: a single‐centre experience. Issue 3 (2nd July 2020)

• Record Type: Journal Article
• Authors: Yi, Eunjue; Lee, Jeong Hyeon; Lee, Jun Hee; Chung, Jae Ho; Lee, Youngseok; Lee, Sungho
• Is Part Of: ANZ journal of surgery. Volume 91:Issue 3(2021)
• Page Start: 291
• Page End: 297
• Publication Date: 2020-07-02
• Subjects: complication -- interstitial lung disease -- outcome -- surgical biopsy; Surgery -- Periodicals; 617.005
• DOI: 10.1111/ans.16112
• Languages: English
• ISSNs: 1445-1433

Abstract

Abstract: Background: The aim of this study was to evaluate mortality and morbidity after surgical lung biopsy in patients with interstitial lung diseases and to investigate perioperative risk factors for complications. Methods: A total of 132 enrolled patients were divided into three groups: group 1 (70), patients with operation scheduled before admission; group 2 (48), patients with operation determined after medical therapy; and group 3 (14), patients with emergent operation followed by steroid therapy. Complications were classified according to the Clavien–Dindo system. The 30‐ and 90‐day mortality and complication rates were evaluated, and perioperative risk factors were investigated. Results: Overall complication rate was 19.7%. The 30‐ and 90‐day in‐hospital mortality rates were 1.5% and 3.0%, respectively. Complication rates more than grade II were significantly different between the three groups ( P = 0.045). Patients in group 1 revealed only class I or II complications and no mortalities. Elevated oxygen demand after operation was an independent risk factor for any complications, complications more than class II and any events ( P < 0.001, P = 0.042 and P < 0.001, respectively). The New York Heart Association Functional Classification (NYHA) class IV was a statistically significant risk factor for any complications ( P = 0.036, odds ratio 7.93). Higher NYHA class (III and IV) showed significantly higher risk in occurrence of any events after lung biopsy. Conclusion: Prepared surgical lung biopsy for interstitial lung disease is feasible with reasonable morbidity. Higher NYHA class and elevated oxygen demand after the surgery could imply post‐operative outcomes. Alternative diagnostic methods such as transbronchial biopsy or bronchoalveolar lavage should be considered prior to surgical lung biopsy especially in high‐risk patients. Abstract : Although surgical lung biopsy is essential for the diagnosis of interstitial lung disease, it could be accompanied by severe complications. Prepared surgical lung biopsy could be performed with reasonable complications rates. Clinicians should be aware of the risks and benefits of surgical diagnosis for interstitial lung diseases.