Value of lung biopsy in pulmonary diseases in children

• Main Authors: Al-Nassar S (Author), Kadamba P (Author), Habib Z (Author)
• Format: Book
• Published: Wolters Kluwer Medknow Publications, 2006-01-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.
• Notes: 0971-9261
• Keywords: Interstitial lung disease; open lung biopsy; thoracoscopy; Pediatrics; RJ1-570; Surgery; RD1-811
• Source: Journal of Indian Association of Pediatric Surgeons, Vol 11, Iss 4, Pp 234-238 (2006)

<b>Purpose: </b> Open lung biopsy (OLB) is claimed to be a sensitive tool for the diagnosis of interstitial lung disease. It is reported to be associated with significant morbidity and mortality. <b> Aim:</b> Evaluate whether lung biopsy helped us to make a specific diagnosis, it had resulted in change in therapy and assessment of its morbidity and mortality.<b> Materials and Methods:</b> This was a retrospective analysis of 91 lung biopsies performed in 83 patients between January 2000 and December 2003. These children were allocated to three groups: a. Primary pulmonary pathology (22), b. Immunocompromised (49) i. Primary immunodeficiency (10), ii. Postchemotherapy and BMT (39), c. Pulmonary metastases from solid tumors (20) <b> Results:</b> A specific diagnosis was reached in 87/91 children (95&#x0025;), but this resulted in a change in therapy (excluding lung meet) in only 23/71 (32&#x0025;). It is lower in those postchemo/BMT 8/39 (20.6&#x0025;). Postoperative morbidity occurred in 11/91 (12&#x0025;) but procedure-related morbidity was only (3.2&#x0025;). Death within a month of the biopsy occurred in six children (6.5&#x0025;), with one (1.1&#x0025;) procedure-related. <b> Conclusion:</b> 1. OLB is a safe procedure at our institution. 2. OLB is a sensitive tool to determine the specific cause of pulmonary infiltrate. 3. Change in therapy expected to be only in 32&#x0025; of patients and even lower in postchemotherapy and BMT children.