PDF(Pubmed)
Abstract：
UNASSIGNED: Surgical lung biopsy (SLB) is required for diagnosis in patients with suspected interstitial lung disease (ILD) if other less invasive diagnostic methods are non-conclusive. We evaluated the outcome of SLB by using centralized databases in a whole-nation patient-cohort.
UNASSIGNED: A population-based retrospective study on 68 consecutive patients (mean age 58 years, 58.8% males) that underwent SLB in Iceland between the years 2008 and 2020. Patient information was obtained from patient charts and peri- and postoperative complications were registered together with 30- and 90-day mortality. Computed tomography (CT) scans, histological biopsies and spirometry results were reviewed, and overall survival (Kaplan-Meier) estimated. Mean follow-up was 61.3 months (range, 3-155 months).
UNASSIGNED: Out of 68 SLB-patients 41 (60.3%) had preoperatively undergone non-conclusive transbronchial biopsies (TBB) obtained with bronchoscopy. Spirometry showed forced vital capacity (FVC) 3.0 L and forced expiratory volume in 1 second (FEV1) 2.3 L, or 73.0% and 71.6% of predicted value, respectively. Video-assisted thoracoscopic surgery (VATS) technique was used in all cases and provided a histologic and disease specific diagnosis in 92.6% of cases; most often being nonspecific interstitial pneumonia (NSIP) (29.4%) and usual interstitial pneumonia (UIP) (23.5%). One patient (1.5%) sustained a major postoperative complication (excessive bleeding) and seven patients (10.3%) minor complications. Median chest tube time and length of stay was 1 and 2 days, respectively. No patients died <90 days postoperatively. Overall survival at 1 and 5 years was 95.6% and 73.5%, respectively, and 5-year survival for NSIP and UIP was 85% and 43.7%, respectively. Long-term mortality for UIP was four times higher when compared with NSIP and other diagnosis.
UNASSIGNED: Lung biopsy with VATS-technique provided a definitive histological and disease specific diagnosis in majority of cases. The procedure is safe, reflected in low complication-rates and short hospital stay, and can therefore be used to diagnose and tailor treatment of ILD patients.
UNASSIGNED: A population-based retrospective study on 68 consecutive patients (mean age 58 years, 58.8% males) that underwent SLB in Iceland between the years 2008 and 2020. Patient information was obtained from patient charts and peri- and postoperative complications were registered together with 30- and 90-day mortality. Computed tomography (CT) scans, histological biopsies and spirometry results were reviewed, and overall survival (Kaplan-Meier) estimated. Mean follow-up was 61.3 months (range, 3-155 months).
UNASSIGNED: Out of 68 SLB-patients 41 (60.3%) had preoperatively undergone non-conclusive transbronchial biopsies (TBB) obtained with bronchoscopy. Spirometry showed forced vital capacity (FVC) 3.0 L and forced expiratory volume in 1 second (FEV1) 2.3 L, or 73.0% and 71.6% of predicted value, respectively. Video-assisted thoracoscopic surgery (VATS) technique was used in all cases and provided a histologic and disease specific diagnosis in 92.6% of cases; most often being nonspecific interstitial pneumonia (NSIP) (29.4%) and usual interstitial pneumonia (UIP) (23.5%). One patient (1.5%) sustained a major postoperative complication (excessive bleeding) and seven patients (10.3%) minor complications. Median chest tube time and length of stay was 1 and 2 days, respectively. No patients died <90 days postoperatively. Overall survival at 1 and 5 years was 95.6% and 73.5%, respectively, and 5-year survival for NSIP and UIP was 85% and 43.7%, respectively. Long-term mortality for UIP was four times higher when compared with NSIP and other diagnosis.
UNASSIGNED: Lung biopsy with VATS-technique provided a definitive histological and disease specific diagnosis in majority of cases. The procedure is safe, reflected in low complication-rates and short hospital stay, and can therefore be used to diagnose and tailor treatment of ILD patients.
摘要：
■如果其他侵入性较小的诊断方法尚无定论，则疑似间质性肺病（ILD）的患者需要进行外科肺活检（SLB）诊断。我们通过在全国患者队列中使用集中数据库来评估SLB的结果。
■一项基于人群的回顾性研究，对68名连续患者（平均年龄58岁，58.8%的男性)在2008年至2020年期间在冰岛接受了SLB。从患者图表中获得患者信息，并记录围手术期和术后并发症以及30天和90天的死亡率。计算机断层扫描(CT)扫描,回顾了组织学活检和肺活量测定结果，和总生存期（Kaplan-Meier）估计。平均随访61.3个月(范围，3-155个月）。
■在68例SLB患者中，有41例（60.3％）在术前接受了支气管镜检查的非结论性经支气管活检（TBB）。肺活量测定显示用力肺活量（FVC）3.0L和1秒用力呼气量（FEV1）2.3L，或预测值的73.0%和71.6%，分别。所有病例均使用了电视辅助胸腔镜手术（VATS）技术，并在92.6％的病例中提供了组织学和疾病特异性诊断；最常见的是非特异性间质性肺炎（NSIP）（29.4％）和普通间质性肺炎（UIP）（23.5％）。1例患者（1.5％）出现严重的术后并发症（出血过多），7例患者（10.3％）出现轻微并发症。中位胸管时间和住院时间为1天和2天，分别。无患者术后<90天死亡。1年和5年总生存率分别为95.6%和73.5%。分别,NSIP和UIP的5年生存率分别为85%和43.7%，分别。与NSIP和其他诊断相比，UIP的长期死亡率高四倍。
■VATS技术肺活检在大多数病例中提供了明确的组织学和疾病特异性诊断。手术是安全的,反映在并发症发生率低和住院时间短，因此可用于诊断和定制ILD患者的治疗。
■一项基于人群的回顾性研究，对68名连续患者（平均年龄58岁，58.8%的男性)在2008年至2020年期间在冰岛接受了SLB。从患者图表中获得患者信息，并记录围手术期和术后并发症以及30天和90天的死亡率。计算机断层扫描(CT)扫描,回顾了组织学活检和肺活量测定结果，和总生存期（Kaplan-Meier）估计。平均随访61.3个月(范围，3-155个月）。
■在68例SLB患者中，有41例（60.3％）在术前接受了支气管镜检查的非结论性经支气管活检（TBB）。肺活量测定显示用力肺活量（FVC）3.0L和1秒用力呼气量（FEV1）2.3L，或预测值的73.0%和71.6%，分别。所有病例均使用了电视辅助胸腔镜手术（VATS）技术，并在92.6％的病例中提供了组织学和疾病特异性诊断；最常见的是非特异性间质性肺炎（NSIP）（29.4％）和普通间质性肺炎（UIP）（23.5％）。1例患者（1.5％）出现严重的术后并发症（出血过多），7例患者（10.3％）出现轻微并发症。中位胸管时间和住院时间为1天和2天，分别。无患者术后<90天死亡。1年和5年总生存率分别为95.6%和73.5%。分别,NSIP和UIP的5年生存率分别为85%和43.7%，分别。与NSIP和其他诊断相比，UIP的长期死亡率高四倍。
■VATS技术肺活检在大多数病例中提供了明确的组织学和疾病特异性诊断。手术是安全的,反映在并发症发生率低和住院时间短，因此可用于诊断和定制ILD患者的治疗。
