Surgical diagnostics of interstitial lung diseases

Abstract

Surgical biopsy – an invasive procedure that may be accompanied by an increased risk of complications and lethality is required in approximately ⅓ cases when diagnosing interstitial lung diseases (ILD). The article summarizes the experience of using surgical diagnostic methods in patients with ILD. Methods. A retrospective analysis of the medical records of patients (n = 104: 61 (59%) men, 43 (41%) women; at the age of 20–78 years) who were operated on for ILD for histological verification of the disease was carried out. The method of choice was video-assisted thoracic edge resection of the lung (VATER). If there are contraindications to VATER, thoracotomy was performed. Patients with spontaneous pneumothorax (SP) episodes had an anamnesis of costal pleuralectomy in order to prevent recurrence. Results. According to the examination data, the average rate of forced expiratory volume in the 1^st second during the preoperative examination was 73.8%, lung diffusion capacity – 63.2% VATER was performed for 99 (95%) patients, OPD – 4 (4%), access conversion – 1 (1%). In 10 (10 %) cases in the anamnesis or at admission is noted by SP. Postoperative complications were observed in 5 (5%) cases. All complications are eliminated without invasive procedures. There were no lethal outcomes. Conclusion. In 94% of cases of ILD, an accurate diagnosis was made using surgical methods, which was significantly reflected in the development of treatment tactics in 82 (79%) patients and allowed for effective anti-relapsing treatment in case of complication of the main disease – SP. This fact testifies to the high diagnostic significance of surgical methods in patients with ILD, and the low level of complications – about their relative safety in properly selected patients.