Thoracoscopic wedge lung biopsy in the diagnosis of pulmonary parenchymal disease

We reviewed our experience in 20 patients [12 women and eight men, aged 52 ± 17 years (mean ± SD); range, 17-81 years] who underwent thoracoscopic wedge lung biopsy for pulmonary parenchymal disease. Fourteen patients were referred as outpatients and six patients were inpatients at the time of biopsy. For the outpatients, the mean room air arterial oxygen tension (Pao₂) was 62 ± 14 mm Hg, the mean percent predicted forced vital capacity (FVC) was 70 ± 20, and the mean percent predicted carbon monoxide diffusing capacity of lung (DLco) was 52 ± 16. The mean duration of chest tube drainage was 1.7 ± 2.4 days, with 12 (86%) of 14 chest tubes removed in 1 day and the mean length of hospitalization was 3.1 ± 2.7 days, with 10 (71%) of 14 patients discharged in 2 days. For the inpatient referrals, the mean duration of pleural drainage was 14 ± 17 days (range, 2-40) and mean length of hospitalization after biopsy was 23 ± 25 days (range, 3-64). A clinically relevant diagnosis was made in 19 (95%) of 20 patients. Management was influenced by the biopsy results in 18 (90%) of 20 patients. Complications occurred in two patients: one had a prolonged air leak that resolved spontaneously with contin-uous suction, and one during general anesthesia developed a mucous plug that was removed bronchoscopically. We conclude that thoracoscopic wedge lung biopsy is an effective and efficient method for evaluating parenchymal lung disease and that it can be performed safely by properly trained and experienced pulmonary physicians.