Our Summary

This research paper talks about a group of lung diseases that affect the supporting framework of the lung’s air sacks. These diseases can impair lung function, making surgeries on the lung risky. The paper suggests that a specific type of surgery, called nonintubated video-assisted thoracoscopic surgery, can safely be used to take lung biopsies in carefully chosen patients who have these diseases. This procedure uses a small camera and instruments passed through small cuts in the chest, avoiding the need for a large incision or using a breathing tube.

FAQs

  1. What are interstitial lung diseases?
  2. What are the risks associated with thoracic surgery for patients with interstitial lung diseases?
  3. What is a nonintubated video-assisted thoracoscopic surgery lung biopsy, and why is it a feasible option for patients with interstitial lung disease?

Doctor’s Tip

A doctor might advise a patient undergoing a lung biopsy to follow pre-operative instructions carefully, such as fasting before the procedure and avoiding certain medications that can increase the risk of bleeding. They may also recommend discussing any concerns or questions with the healthcare team and preparing for post-operative care, including rest and monitoring for any potential complications. Additionally, the doctor may emphasize the importance of attending follow-up appointments to monitor recovery and discuss biopsy results.

Suitable For

Patients who are typically recommended for lung biopsy include those with suspected interstitial lung diseases, such as idiopathic pulmonary fibrosis, sarcoidosis, and connective tissue diseases. These patients may have symptoms such as shortness of breath, cough, and fatigue, as well as abnormal findings on chest imaging studies. Additionally, patients who have failed to respond to initial treatments or whose diagnosis remains uncertain despite extensive evaluation may also be recommended for a lung biopsy. It is important to carefully select patients for lung biopsy, as those with severe respiratory compromise or significant comorbidities may not be suitable candidates for the procedure.

Timeline

Before lung biopsy:

  1. Patient presents with symptoms such as shortness of breath, cough, and chest pain.
  2. Patient undergoes a physical exam, chest X-ray, and possibly a CT scan to determine the need for a lung biopsy.
  3. Patient may undergo pulmonary function tests to assess lung function and overall health.
  4. Patient may receive instructions on fasting before the procedure and medication adjustments if needed.

During lung biopsy:

  1. Patient is prepped for the procedure and given local anesthesia.
  2. A small incision is made in the chest wall, and a biopsy tool is inserted to collect a sample of lung tissue.
  3. The sample is sent to a lab for analysis.
  4. The incision is closed, and the patient is monitored for any immediate complications.

After lung biopsy:

  1. Patient may experience pain or discomfort at the biopsy site, which can be managed with pain medication.
  2. Patient may be advised to rest and avoid strenuous activities for a period of time.
  3. Results of the biopsy are discussed with the patient, and further treatment options are considered based on the findings.
  4. Follow-up appointments may be scheduled to monitor recovery and assess the effectiveness of treatment.

What to Ask Your Doctor

  1. What is the purpose of the lung biopsy in my case?
  2. What are the potential risks and complications associated with the lung biopsy procedure?
  3. How will the biopsy be performed (e.g. through surgery or minimally invasive techniques)?
  4. Will I need to be intubated for the procedure, or is a nonintubated approach an option?
  5. What are the expected outcomes of the lung biopsy in terms of diagnosis and treatment planning?
  6. How long will it take to recover from the biopsy procedure?
  7. Will I need to stay in the hospital after the biopsy, and if so, for how long?
  8. What are the alternative diagnostic methods to a lung biopsy in my case?
  9. How will the biopsy results be communicated to me, and when can I expect to receive them?
  10. Are there any specific instructions or precautions I should follow before and after the lung biopsy procedure?

Reference

Authors: Kim TH, Cho JH. Journal: Thorac Surg Clin. 2020 Feb;30(1):41-48. doi: 10.1016/j.thorsurg.2019.08.005. PMID: 31761283