Therapeutic Direction Versus Adverse Outcomes in Children Undergoing Lung Biopsy
| Autor: | Justin A. Sobrino, Hanna Alemayehu, Shawn D. St. Peter, Joseph A. Sujka, Rebecca M. Rentea, Nhatrang Le, Leo Andrew Benedict |
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| Rok vydání: | 2019 |
| Předmět: |
Lung Diseases
Reoperation medicine.medical_specialty Adolescent Biopsy Clinical Decision-Making Lung biopsy Risk Assessment 03 medical and health sciences Postoperative Complications 0302 clinical medicine Interquartile range Thoracoscopy Humans Medicine Child Adverse effect Lung Retrospective Studies medicine.diagnostic_test business.industry Infant Perioperative medicine.disease Surgery Respiratory failure Pneumothorax Child Preschool 030220 oncology & carcinogenesis 030211 gastroenterology & hepatology business Follow-Up Studies |
| Zdroj: | Journal of Surgical Research. 236:106-109 |
| ISSN: | 0022-4804 |
| DOI: | 10.1016/j.jss.2018.10.025 |
| Popis: | Background Lung biopsy is part of the diagnostic workup for multiple diseases. Although the morbidity of the procedure has decreased with the use of thoracoscopy, lung biopsy still holds substantial risk for patients. Therefore, we evaluated the likelihood of lung biopsies impacting treatment compared to complications. Material and methods This was a single-institution, retrospective chart review of patients less than aged 18 y undergoing lung biopsy from 2010 to 2016. Details of demographics, hospital course, adverse events, complications, pathology, and follow-up were recorded. All values are reported as medians with interquartile range. Results Thirty-seven patients met inclusion criteria. Median age was 7 y old (interquartile range 1.4, 15). Eighty-seven percent (33) of biopsies were performed thoracoscopically, with a 3% conversion rate. Adverse events occurred in 25% (9) of cases with the majority involving prolonged respiratory failure (n = 7). Complications occurred in 16% (6) of cases including pneumothorax (13%, n = 5) and cardiac arrest (3%, n = 1). A third of these complications (n = 2) required reoperation, and both were decompressions of tension pneumothoraces. Pathology established a diagnosis in 62% (n = 23) of cases, yet treatment was changed in only 43% of cases. No preoperative variables were associated with the pathology establishing a diagnosis or changing treatment. Conclusions Lung biopsy for questionable pulmonary disease changed treatment in less than half of cases, with significant perioperative morbidity. Careful consideration should therefore be given to who would benefit most from lung biopsy. |
| Databáze: | OpenAIRE |
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