Assessing the Safety and Efficacy of Thoracoscopic Lung Biopsy in Patients with Interstitial Lung Disease

Background: Interstitial lung disease [ILD] is a difficult-to-treat disease. The patient continues treatment for his/her whole life. However, certain causes – when diagnosed - could change their treatment plan. Radiological investigations cannot elicit the underlying pathology 100%. Thus, transthora...

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Autores principales:	Mohamed Mustafa Elsheikh, Hussein Ahmad Abo-Elyazed, Kamel Abdelghaffar, Atef Alrifai, Salah Eldeen Semary
Formato:	article
Lenguaje:	EN
Publicado:	Al-Azhar University, Faculty of Medicine (Damietta) 2021
Materias:	interstitial lung disease transthoracic lung biopsy efficacy safety Medicine (General) R5-920
Acceso en línea:	https://doaj.org/article/7d538809c51946048ef5cb7c8fa06a3c
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spelling	oai:doaj.org-article:7d538809c51946048ef5cb7c8fa06a3c2021-12-02T19:33:14ZAssessing the Safety and Efficacy of Thoracoscopic Lung Biopsy in Patients with Interstitial Lung Disease2636-41742682-378010.21608/ijma.2021.63433.1265https://doaj.org/article/7d538809c51946048ef5cb7c8fa06a3c2021-10-01T00:00:00Zhttps://ijma.journals.ekb.eg/article_189868_6b6689dcdfa1077ecfa5f77df01a4d9f.pdfhttps://doaj.org/toc/2636-4174https://doaj.org/toc/2682-3780Background: Interstitial lung disease [ILD] is a difficult-to-treat disease. The patient continues treatment for his/her whole life. However, certain causes – when diagnosed - could change their treatment plan. Radiological investigations cannot elicit the underlying pathology 100%. Thus, transthoracic lung biopsy is of utmost importance, especially in undiagnosed patients. But, it is not free of risk, and thus, its use is still controversial.Aim of the work: This work aims to evaluate the role of medical thoracoscopic lung biopsy [TLB] in diagnosing diffuse parenchymal lung diseases.Patients and Methods: Fifty patients with diffuse lung infiltrate on high-resolution computed tomography [HCRT] of unconfirmed diagnosis were included. All patients have been submitted to detailed clinical examination and specific laboratory investigations. Furthermore, all had high resolution computed tomography, pulmonary function tests], echocardiography, arterial blood gas analysis, and bronchoalveolar lavage assessment. The thoracoscopic lung biopsy was performed under local anesthesia. The specimens were preserved in formalin containing cups till examination. Patients were followed up, and any complications were documented.Results: The lung HCRT revealed ground-glass opacity [44%], reticulonodular interstitial pattern [38%], honeycombing [14%], crazy paving [10.0%], and consolidation [20.0%]. The histopathology revealed alveolar proteinosis [2.0%], alveolar hemosidrosis [2.0%], hypersensitivity pneumonitis [24.0%], sarcoidosis [8.0%], nonspecific interstitial pneumonia [20%], Idiopathic pulmonary fibrosis [12.0%], respiratory bronchiolitis ILD [18%], and desquamative ILD [14.0%]. All patients positive on HCRT had pathological change. Complications were [12%] bulla in partnehymea, [4%] plural disear, [2%] pneumothorax, and 2% died during follow up duration.Conclusion: TLB is an effective and relatively safe, minimally invasive intervention for interstitial lung disease diagnosis. Accordingly, it must be considered a standard diagnostic tool for undiagnosed suspected cases.Mohamed Mustafa ElsheikhHussein Ahmad Abo-ElyazedKamel AbdelghaffarAtef AlrifaiSalah Eldeen SemaryAl-Azhar University, Faculty of Medicine (Damietta)articleinterstitial lung diseasetransthoraciclung biopsyefficacysafetyMedicine (General)R5-920ENInternational Journal of Medical Arts, Vol 3, Iss 4, Pp 1777-1783 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	interstitial lung disease transthoracic lung biopsy efficacy safety Medicine (General) R5-920
spellingShingle	interstitial lung disease transthoracic lung biopsy efficacy safety Medicine (General) R5-920 Mohamed Mustafa Elsheikh Hussein Ahmad Abo-Elyazed Kamel Abdelghaffar Atef Alrifai Salah Eldeen Semary Assessing the Safety and Efficacy of Thoracoscopic Lung Biopsy in Patients with Interstitial Lung Disease
description	Background: Interstitial lung disease [ILD] is a difficult-to-treat disease. The patient continues treatment for his/her whole life. However, certain causes – when diagnosed - could change their treatment plan. Radiological investigations cannot elicit the underlying pathology 100%. Thus, transthoracic lung biopsy is of utmost importance, especially in undiagnosed patients. But, it is not free of risk, and thus, its use is still controversial.Aim of the work: This work aims to evaluate the role of medical thoracoscopic lung biopsy [TLB] in diagnosing diffuse parenchymal lung diseases.Patients and Methods: Fifty patients with diffuse lung infiltrate on high-resolution computed tomography [HCRT] of unconfirmed diagnosis were included. All patients have been submitted to detailed clinical examination and specific laboratory investigations. Furthermore, all had high resolution computed tomography, pulmonary function tests], echocardiography, arterial blood gas analysis, and bronchoalveolar lavage assessment. The thoracoscopic lung biopsy was performed under local anesthesia. The specimens were preserved in formalin containing cups till examination. Patients were followed up, and any complications were documented.Results: The lung HCRT revealed ground-glass opacity [44%], reticulonodular interstitial pattern [38%], honeycombing [14%], crazy paving [10.0%], and consolidation [20.0%]. The histopathology revealed alveolar proteinosis [2.0%], alveolar hemosidrosis [2.0%], hypersensitivity pneumonitis [24.0%], sarcoidosis [8.0%], nonspecific interstitial pneumonia [20%], Idiopathic pulmonary fibrosis [12.0%], respiratory bronchiolitis ILD [18%], and desquamative ILD [14.0%]. All patients positive on HCRT had pathological change. Complications were [12%] bulla in partnehymea, [4%] plural disear, [2%] pneumothorax, and 2% died during follow up duration.Conclusion: TLB is an effective and relatively safe, minimally invasive intervention for interstitial lung disease diagnosis. Accordingly, it must be considered a standard diagnostic tool for undiagnosed suspected cases.
format	article
author	Mohamed Mustafa Elsheikh Hussein Ahmad Abo-Elyazed Kamel Abdelghaffar Atef Alrifai Salah Eldeen Semary
author_facet	Mohamed Mustafa Elsheikh Hussein Ahmad Abo-Elyazed Kamel Abdelghaffar Atef Alrifai Salah Eldeen Semary
author_sort	Mohamed Mustafa Elsheikh
title	Assessing the Safety and Efficacy of Thoracoscopic Lung Biopsy in Patients with Interstitial Lung Disease
title_short	Assessing the Safety and Efficacy of Thoracoscopic Lung Biopsy in Patients with Interstitial Lung Disease
title_full	Assessing the Safety and Efficacy of Thoracoscopic Lung Biopsy in Patients with Interstitial Lung Disease
title_fullStr	Assessing the Safety and Efficacy of Thoracoscopic Lung Biopsy in Patients with Interstitial Lung Disease
title_full_unstemmed	Assessing the Safety and Efficacy of Thoracoscopic Lung Biopsy in Patients with Interstitial Lung Disease
title_sort	assessing the safety and efficacy of thoracoscopic lung biopsy in patients with interstitial lung disease
publisher	Al-Azhar University, Faculty of Medicine (Damietta)
publishDate	2021
url	https://doaj.org/article/7d538809c51946048ef5cb7c8fa06a3c
work_keys_str_mv	AT mohamedmustafaelsheikh assessingthesafetyandefficacyofthoracoscopiclungbiopsyinpatientswithinterstitiallungdisease AT husseinahmadaboelyazed assessingthesafetyandefficacyofthoracoscopiclungbiopsyinpatientswithinterstitiallungdisease AT kamelabdelghaffar assessingthesafetyandefficacyofthoracoscopiclungbiopsyinpatientswithinterstitiallungdisease AT atefalrifai assessingthesafetyandefficacyofthoracoscopiclungbiopsyinpatientswithinterstitiallungdisease AT salaheldeensemary assessingthesafetyandefficacyofthoracoscopiclungbiopsyinpatientswithinterstitiallungdisease
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Assessing the Safety and Efficacy of Thoracoscopic Lung Biopsy in Patients with Interstitial Lung Disease

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