Mustafa VAYVADA, Çağatay TEZEL, Emine AKSOY, Tülin SEVİM, Hakan KIRAL, Mustafa AKYIL, Ayçim ŞEN, Fatma AKYIL TOKGÖZ, Volkan BAYSUNGUR

Surgical lung biopsy for differential diagnosis of interstitial lung disease

Amaç: Bu çalışmada, interstisyel akciğer hastalığının ayırıcı tanısı için cerrahi akciğer biyopsisinin tanısal değeri ve tanıyı etkileyen faktörler araştırıldı. Çalışma planı: Hastanemizde May 2008 - Aralık 2014 tarihleri arasında cerrahi akciğer biyopsisi uygulanan 202 hastanın (91 erkek, 111 kadın; ort. yaş 49±12 yıl; dağılım 18-78 yıl) tıbbi kayıtları retrospektif olarak incelendi. Hastaların demografik özellikleri, cerrahi tipi, biyopsi sayısı ve yeri ve histopatolojik bulgular ışığında ulaşılan son tanıları kaydedildi. Son tanılara göre, hastalar spesifik tanıya ulaşılanlar (grup 1) ve spesifik tanıya ulaşılamayanlar (grup 2) olarak iki gruba ayrıldı. Cerrahi işlemin son tanıya olan etkisi araştırıldı. Bulgular: Sol akciğer daha sık örneklenmiş (%72) ve işlemlerin %75'i tek bir biyopsi ile sonlanmış idi. Toplam biyopsi sayısı 255 idi. Tüm örneklerin %44'ü orta lob veya linguladan alınmış idi. Histopatolojik olarak son tanıya ulaşılan ve klinik ve radyolojik olarak doğrulanan hasta oranı %80 idi (grup 1). Cinsiyet, (p=0.161), örnek sayısı (p=0.541), akciğer tarafı (p=0.954) ve akciğer segmenti (p=0.592) tanıya ulaşma oranını etkilememiş idi. Hastaların %2'sinde mortalite, %1.5'inde majör ve %9.5'inde minör komplikasyon gözlemlendi. Biyopsi yeri ve sayısı ile komplikasyon gelişmesi arasında ilişki saptanmadı (p>0.05). Sonuç: Cerrahi akciğer biyopsileri, düşük olasılıkla da olsa, morbidite ve mortalite ile ilişkilidir. Tüm işlemlerde spesifik tanıya ulaşılamamaktadır. Cerrahi biyopsinin yeri, tipi ve sayısı tanı oranını anlamlı olarak etkilememektedir.

İnterstisyel akciğer hastalığının ayırıcı tanısında cerrahi akciğer biyopsisi

Background: This study aims to investigate the diagnostic yield of surgical lung biopsy for the differential diagnosis of interstitial lung disease and the factors affecting diagnosis.Methods: We retrospectively reviewed medical records of 202 patients (91 males, 111 females; mean age 49±12 years; range 18 to 78 years) who underwent surgical lung biopsy in our hospital between May 2008 and December 2014. We recorded patients' demographic characteristics, surgery type, number and localization of biopsies, and final diagnoses established in light of histopathological findings. According to the final diagnoses, we divided patients into two groups as patients with an established specific diagnosis (group 1) and patients without an established specific diagnosis (group 2). We investigated the effect of surgical procedure on final diagnosis.Results: Left lung was more frequently sampled (72%) and 75% of the procedures ended up with a single biopsy. Total number of biopsies was 255. Of all samples, 44% were taken from the middle lobe or lingula. Rate of patients with a histopathologically established and clinically and radiologically verified final diagnosis was 80% (group 1). Gender (p=0.161), number of samples (p=0.541), lung side (p=0.954), or lung segment (p=0.592) did not affect the rate of establishing a diagnosis. Of the patients, mortality was observed in 2%, major complications in 1.5%, and minor complications in 9.5%. No relationship was detected between localization or number of biopsies and development of complications (p>0.05).Conclusion: Albeit with low probability, surgical lung biopsies are correlated with morbidity and mortality. Not all procedures result in a specific diagnosis. Localization, type or number of biopsies do not affect the diagnosis rate significantly.

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