Our Summary

This research paper looks at the safety and tolerance of a surgical procedure called video-assisted thoracoscopic surgery (VATS) in diagnosing a type of lung condition known as interstitial lung disease (ILD). The study was conducted at a hospital called Inova Fairfax, where data from patients who underwent this surgery from December 2012 to September 2019 were collected and analyzed.

The results showed that out of 268 patients who had the surgery, the average patient age was 63, majority were men, and 25% were diagnosed with a specific type of ILD called idiopathic pulmonary fibrosis. Among patients who had the surgery scheduled, the complication rate was 8% and there were no deaths. Deaths occurred only among patients who were already in the hospital before the surgery. The study also found that complications were less likely when the surgery was requested by a team of specialists in ILD.

Most importantly, the study found that the VATS procedure could be safely done and patients could be discharged on the same day. The authors concluded that these findings support the idea that this surgery should be considered more often when a tissue sample is needed to diagnose ILD.

FAQs

  1. What is the video-assisted thoracoscopic surgery (VATS) and what is it used to diagnose?
  2. What were the main findings of the study conducted at Inova Fairfax on the safety and tolerance of VATS?
  3. Did the study find any correlation between the team requesting the surgery and the likelihood of complications during the VATS procedure?

Doctor’s Tip

A helpful tip a doctor might tell a patient about lung biopsy is to follow all pre-operative instructions provided by the healthcare team, such as fasting before the procedure and avoiding certain medications. It is also important to inform the healthcare team about any allergies or medical conditions you may have. After the procedure, it is essential to follow post-operative care instructions, such as taking prescribed medications and avoiding strenuous activities until fully healed. Finally, make sure to attend all follow-up appointments to monitor your recovery and discuss the results of the biopsy with your healthcare provider.

Suitable For

Patients who are typically recommended for a lung biopsy, specifically a VATS procedure, include those with suspected ILD, such as idiopathic pulmonary fibrosis, sarcoidosis, or connective tissue disease-associated ILD. These patients may have symptoms such as shortness of breath, cough, fatigue, or unexplained weight loss, and may have abnormal findings on chest imaging studies such as chest X-rays or CT scans.

In addition, patients who have not responded to initial treatments for their lung condition or whose diagnosis remains unclear despite other diagnostic tests may also be recommended for a lung biopsy. Patients with a history of exposure to certain environmental factors, such as asbestos or silica, or those with a family history of ILD may also be candidates for a lung biopsy to help confirm a diagnosis.

Overall, patients who are considered for a lung biopsy are those who require a definitive diagnosis in order to guide appropriate treatment decisions and improve their outcomes. It is important for these patients to be evaluated by a multidisciplinary team of specialists, including pulmonologists, radiologists, and thoracic surgeons, to determine the most appropriate approach to obtaining a tissue sample for diagnosis.

Timeline

Before the lung biopsy:

  1. Patient experiences symptoms such as shortness of breath, coughing, and chest pain that lead to a referral for a lung biopsy.
  2. Patient undergoes consultations with a pulmonologist and thoracic surgeon to discuss the procedure and potential risks.
  3. Patient undergoes pre-operative testing such as blood work, chest x-rays, and pulmonary function tests to assess their overall health and lung function.

After the lung biopsy:

  1. Patient is admitted to the hospital on the day of the procedure and undergoes general anesthesia.
  2. Surgeon performs the VATS procedure, using a small camera and instruments to remove a tissue sample from the lung.
  3. Patient is closely monitored in the recovery room for any complications such as bleeding or infection.
  4. Patient is discharged on the same day or the following day, with instructions for post-operative care and follow-up appointments.
  5. Pathologist analyzes the tissue sample to determine a diagnosis and treatment plan for the patient’s ILD.

Overall, the patient’s experience before and after a lung biopsy involves thorough evaluation, careful planning, and close monitoring to ensure a safe and successful outcome.

What to Ask Your Doctor

  1. What type of lung biopsy procedure is recommended for my specific condition?
  2. What are the potential risks and complications associated with a lung biopsy?
  3. How will the biopsy results be used to determine my diagnosis and treatment plan?
  4. How experienced is the medical team in performing lung biopsies for my specific condition?
  5. What is the recovery process like after a lung biopsy procedure?
  6. Are there any alternative diagnostic tests or procedures that could be considered instead of a lung biopsy?
  7. How long will it take to receive the biopsy results?
  8. What follow-up care or monitoring will be needed after the biopsy procedure?
  9. How likely is it that the biopsy will provide a definitive diagnosis for my condition?
  10. Are there any specific factors about my health history that could affect the safety or success of a lung biopsy procedure?

Reference

Authors: Pastre J, Khandhar S, Barnett S, Ksovreli I, Mani H, Brown AW, Shlobin OA, Ahmad K, Khangoora V, Aryal S, Morris DL, King CS, Nathan SD. Journal: Ann Am Thorac Soc. 2021 Mar;18(3):460-467. doi: 10.1513/AnnalsATS.202006-759OC. PMID: 32970474