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Vol. 32. Issue 1.
Pages 10-13 (January 1996)
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Vol. 32. Issue 1.
Pages 10-13 (January 1996)
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Biopsia pulmonar en la enfermedad intersticial difusa: videotoracoscopia frente a toracotomía
Lung biopsy in diffuse interstitial disease: videothoracoscopy versus thoracotomy
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M.A. Callejas Pérez*, J. Belda Sanchis, X. Baldó Padró, E. Canalís Arrayás, M. Catalán Biel, J.M. Gimferrer Garolera
Servicio de Cirugía Torácica (Prof. Dr. J. Sánchez-Lloret Tortosa). Hospital Clínic i Provincial. Barcelona
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El objetivo del trabajo es evaluar y comparar los resultados de las biopsias pulmonares realizadas por videotoracoscopia (VTC) y por toracotomía limitada (TL) en la enfermedad intersticial difusa entre los años 1992 y 1994. En este período se han realizado 45 biopsias pulmonares (25 varones y 20 mujeres) con una edad media de 56 años. Treinta y una biopsias se efectuaron por VTC (grupo I) y 14 mediante toracotomía limitada (grupo II). En cada uno de los casos estudiados se determinó el tiempo quirúrgico, los días de estancia postoperatoria, el tiempo de permanencia del drenaje pleural y el volumen de la pieza de biopsia.

Los resultados han mostrado que el diagnóstico se obtuvo en el 100% de los casos. La duración media de la intervención quirúrgica (tiempo quirúrgico) fue de 49,3 minutos para el grupo I y de 58,2 minutos para el grupo II. La estancia media postoperatoria fue de 6,7 días para el grupo I y de 10,1 días para el grupo II. El tiempo medio de permanencia del drenaje pleural fue de 3,8 días para el grupo I y de 5,9 días para el grupo II. El volumen medio de la pieza de biopsia fue de 6,5 cm3 para el grupo I y de 5,18 cm3 para el grupo II. La mortalidad fue de un paciente que pertenecía al grupo I sin relación directa con la técnica quirúrgica. En conclusión, la biopsia pulmonar por VTC es una técnica efectiva y útil para el diagnóstico de las enfermedades intersticiales difusas del pulmón. El material que se obtiene es en todo comparable con el de la biopsia por toracotomía. Disminuye de forma significativa (p < 0,05) la estancia media hospitalaria y el tiempo de permanencia del drenaje postoperatorio.

Palabras clave:
Biopsia pulmonar
Enfermedad intersticial difusa
Videotoracoscopia

The aim of this work was to evaluate and compare the results of lung biopsies performed by videothoracoscopy (VT) and minithoracotomy (MT) in diffuse interstitial disease between 1992 and 1994. during which period 45 lung biopsies were performed on patients (20 women) with a mean age of 56 years. Thirty-one biopsies were performed by VT (group I) and 14 by MT (group II). For all patients we recorded duration of procedure, days to discharge after surgery, total time with a pleural drain in place, and volume of tissue sample.

Diagnosis was possible in all cases. Mean duration of surgery was 49.3 minutes for group I and 58.2 minutes for group II. Mean time to discharge was 6.7 days for group I and 10.1 for group II. Mean time of pleural drainage was 3.8 days for group I and 5.9 days for group II. Mean volume of tissue sample was 6.5 cm3 for group I and 5.18 cm3 for group II. One patient died in group I from causes unrelated to surgical technique. In conclusion, lung biopsy with VT is effective and useful for diagnosing diffuse interstitial lung diseases. The sample obtained is in every way comparable to that obtained by thoracotomy. Mean hospital stay and mean time of postoperative drainage decreases significantly (p < 0.05) with VT.

Key words:
Lung biopsy
Diffuse interstitial disease
Video assisted thoracoscopy
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Copyright © 1996. Sociedad Española de Neumología y Cirugía Torácica
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