Comparison of Thoracotomy and Videothorocoscopy for Taking Lung Biopsies in the Diagnosis of Interstitial Lung Diseases

OBJECTIVE: As a heterogeneous group of diseases with or without known aetiologies, interstitial lung diseases (ILD) have common clinical, radiological, and physiological properties, including the involvement of the lung interstitium. Bronchoscopy does not obtain typical findings for the diagnosis of ILD. The main aim of bronchoscopy is to provide the diagnosis by taking bronchoalveolar lavage (BAL) and transbronchial lung biopsy (TBLB) materials. Lung biopsy is the most reliable diagnostic method in ILD. Lung biopsy can be accompanied by thoracotomy or videothoracoscopy.MATERIAL AND METHODS: The purpose of this study was to determine the preferred type of surgery in the diagnosis of ILD, comparing the lung biopsy method by thoracotomy with the lung biopsy method by videothoracoscopy, in terms of the average operation time, the total cost of the surgery, the mean chest tube duration, diagnostic efficiency, postoperative complications, postoperative hospital stay and total hospital stay.RESULTS: Twenty patients in the thoracotomy group and 19 patients in the videothoracoscopic group for lung biopsy were studied. At the end of the study, no significant difference was observed for the age, gender, operating time, chest tube, duration of stay, diagnostic efficiency, and total duration of hospital stay between the two groups. However, postoperative hospital stay was significantly longer in the videothoracoscopic biopsy group. Again, the videothoracoscopic biopsy method was found to be significantly more cost-effective implementation in comparison with the thoracotomy method.CONCLUSION: The videothoracoscopic biopsy method should be preferred against the biopsy method with thoracotomy, as it has advantages such as less postoperative pain, a cosmetically small incision and more patient comfort, despite the high cost of application.