Thoracoscopic biopsy in children with diffuse parenchymal lung disease
Identifieur interne : 001958 ( Main/Exploration ); précédent : 001957; suivant : 001959Thoracoscopic biopsy in children with diffuse parenchymal lung disease
Auteurs : Sylvia Glüer [Allemagne] ; Nicolaus Schwerk [Allemagne] ; Marc Reismann [Allemagne] ; Martin L. Metzelder [Allemagne] ; Rainer Nustede [Allemagne] ; Benno M. Ure [Allemagne] ; Monika Gappa [Allemagne]Source :
- Pediatric Pulmonology [ 8755-6863 ] ; 2008-10.
English descriptors
- Teeft :
- Abca3 mutation, Absorbable sutures, Acta paediatr, Adequate volume, Adult patients, Allergen avoidance, Antibiotic therapy, Atypical mycobacteria, Biopsy, Biopsy site, Bolus, Bolus therapy, Cardiothorac surg, Chest tube, Chest tubes, Chronic pneumonitis, Clinical signs, Current literature, Current series, Diffuse lung disease, Diffuse parenchymal lung disease, Dpld, Dyspnea, Electron microscopy, Further intraoperative complications, General anesthesia, Giant cells, High dose, Histological diagnosis, Histopathological, Histopathological diagnosis, Immunocompetent children, Individual cases, Interstitial, Interstitial lung disease, Interstitial pneumonitis, Intrathoracic lesions, Lung, Lung biopsy, Lung disease, Median, Morbidity, Nger clubbing, Open lung biopsy, Other postoperative complications, Pediatr, Pediatr pulmonol, Pediatr surg, Pediatr surg discussion, Pediatric, Pediatric pulmonology, Pediatric surgery, Pneumonitis, Postoperative, Progressive dyspnea, Pulmonary function tests, Range days, Recurrent pneumonia, Respiratory distress, Respiratory failure, Satisfactory control, Steroid, Steroid bolus therapy, Steroid therapy, Surfactant protein, Surg, Systemic corticosteroids, Systemic steroids, Thoracoscopic, Thoracoscopic biopsy, Thoracoscopic lung biopsy, Thoracoscopic surgery, Thoracoscopy, Thoracotomy, Treatment decisions, Typical anamnestic, Vat, Vats biopsy, Vats lung biopsy.
Abstract
Lung biopsy is necessary for establishing the diagnosis in patients with otherwise unclassified diffuse or localized parenchymal lung disease. This study aimed to assess the safety and accuracy of video‐assisted thoracoscopic (VATS) lung biopsy in children with diffuse parenchymal lung disease (DPLD). In addition we aimed to evaluate the value of this technique with respect to the spectrum of diseases encountered, correlating histological diagnosis with treatment decisions and subsequent clinical outcome. Data from all patients (n = 21) who underwent surgical lung biopsy for suspected DPLD between March 2001 and August 2006 were collected prospectively. Median age was 3 years, 8 months (range 11 days to 15 years, 2 months). All lung biopsies were performed by VATS under general anesthesia. Median operative time was 45 min (range 25–100 min). Conversion to minithoracotomy due to cardiorespiratory difficulties was necessary in two young infants. There were no further intraoperative complications. In 8/21 children, a chest tube was inserted postoperatively for a median of 2 days (range 1–5 days). In one patient, prolonged air‐leakage was managed thoracoscopically on postoperative day 9. There were no other postoperative complications. The specimens were of adequate volume and quality and a histopathological diagnosis was obtained for all patients. There was a broad spectrum of different diagnoses which led to specific therapeutic decisions. Subsequent medical treatment was beneficial in the majority of the patients. In conclusion, VATS is a safe and effective procedure for diagnosis of children with suspected DPLD. Diagnostic accuracy is high, morbidity rates are low, and patients may benefit from avoiding thoracotomy. Pediatr Pulmonol. 2008; 43:992–996. © 2008 Wiley‐Liss, Inc.
Url:
DOI: 10.1002/ppul.20896
Affiliations:
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This study aimed to assess the safety and accuracy of video‐assisted thoracoscopic (VATS) lung biopsy in children with diffuse parenchymal lung disease (DPLD). In addition we aimed to evaluate the value of this technique with respect to the spectrum of diseases encountered, correlating histological diagnosis with treatment decisions and subsequent clinical outcome. Data from all patients (n = 21) who underwent surgical lung biopsy for suspected DPLD between March 2001 and August 2006 were collected prospectively. Median age was 3 years, 8 months (range 11 days to 15 years, 2 months). All lung biopsies were performed by VATS under general anesthesia. Median operative time was 45 min (range 25–100 min). Conversion to minithoracotomy due to cardiorespiratory difficulties was necessary in two young infants. There were no further intraoperative complications. In 8/21 children, a chest tube was inserted postoperatively for a median of 2 days (range 1–5 days). In one patient, prolonged air‐leakage was managed thoracoscopically on postoperative day 9. There were no other postoperative complications. The specimens were of adequate volume and quality and a histopathological diagnosis was obtained for all patients. There was a broad spectrum of different diagnoses which led to specific therapeutic decisions. Subsequent medical treatment was beneficial in the majority of the patients. In conclusion, VATS is a safe and effective procedure for diagnosis of children with suspected DPLD. Diagnostic accuracy is high, morbidity rates are low, and patients may benefit from avoiding thoracotomy. Pediatr Pulmonol. 2008; 43:992–996. © 2008 Wiley‐Liss, Inc.</div></front></TEI><affiliations><list><country><li>Allemagne</li></country><region><li>Basse-Saxe</li></region><settlement><li>Hanovre</li></settlement></list><tree><country name="Allemagne"><region name="Basse-Saxe"><name sortKey="Gluer, Sylvia" sort="Gluer, Sylvia" uniqKey="Gluer S" first="Sylvia" last="Glüer">Sylvia Glüer</name></region><name sortKey="Gappa, Monika" sort="Gappa, Monika" uniqKey="Gappa M" first="Monika" last="Gappa">Monika Gappa</name><name sortKey="Gluer, Sylvia" sort="Gluer, Sylvia" uniqKey="Gluer S" first="Sylvia" last="Glüer">Sylvia Glüer</name><name sortKey="Gluer, Sylvia" sort="Gluer, Sylvia" uniqKey="Gluer S" first="Sylvia" last="Glüer">Sylvia Glüer</name><name sortKey="Metzelder, Martin L" sort="Metzelder, Martin L" uniqKey="Metzelder M" first="Martin L." last="Metzelder">Martin L. Metzelder</name><name sortKey="Nustede, Rainer" sort="Nustede, Rainer" uniqKey="Nustede R" first="Rainer" last="Nustede">Rainer Nustede</name><name sortKey="Reismann, Marc" sort="Reismann, Marc" uniqKey="Reismann M" first="Marc" last="Reismann">Marc Reismann</name><name sortKey="Schwerk, Nicolaus" sort="Schwerk, Nicolaus" uniqKey="Schwerk N" first="Nicolaus" last="Schwerk">Nicolaus Schwerk</name><name sortKey="Ure, Benno M" sort="Ure, Benno M" uniqKey="Ure B" first="Benno M." last="Ure">Benno M. Ure</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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