Medknow Publications on behalf of the Indian Association of Pediatric Surgeons
Abstract
Purpose: 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. Aim: 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. Materials and Methods: 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) Results: A specific diagnosis was
reached in 87/91 children (95%), but this resulted in a change in
therapy (excluding lung meet) in only 23/71 (32%). It is lower in those
postchemo/BMT 8/39 (20.6%). Postoperative morbidity occurred in 11/91
(12%) but procedure-related morbidity was only (3.2%). Death within a
month of the biopsy occurred in six children (6.5%), with one (1.1%)
procedure-related. Conclusion: 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% of patients and even lower in postchemotherapy and BMT children
