Investigation of postoperative pulmonary complications in patients undergoing lung biopsy for interstitial lung disease

Investigation of Postoperative Pulmonary Complications in Patients Undergoing Lung Biopsy for Interstitial Lung Disease Objective: The aim of this study was to evaluate the postoperative complications in patients who underwent lung biopsy with a prediagnosis of interstitial lung disease in our clinic and whose pathology results were compatible with interstitial lung disease in the postoperative period of 1 week-1 month. Materials and Methods: Between 1 January 2017 and 31 December 2022, patients who underwent lung biopsy with a prediagnosis of interstitial lung disease in the Department of Thoracic Surgery of Akdeniz University Hospital and whose pathology results were compatible with interstitial lung disease were retrospectively scanned from the hospital automation system and patients whose clinical follow-up, pathology results, preoperative pulmonary function tests and radiological imaging were available were included in the study. Results: The mean age of the patients was 56.96 ± 11.18 years, 50.7% (n=71) were female and 49.3% (n=69) were male. 52.1% (n=73) of the patients were under the age of 60 years. The mean body mass index of the patients was 28.89 ± 5.33. While 50% (n=70) of the patients were non-smokers, 50% (n=70) had smoked or were still smoking before the time of operation. The mean smoking rate of the patients was 16.54±23.68 p/year. 74.3% (n=104) of the patients had at least one comorbidity. The most common postoperative pathological diagnoses were as follows: 26.4% UİP (n=37), 17.9% HSP (n=25), 15.7% NSİP (n=22). In 5% (n=7) of the patients, the diagnosis could not be made due to insufficient sample. VATS operation was performed in 40% (n=56) of the patients. The most common biopsy localisation of the patients (n=99, 71%) was from all 3 lobes of the right lung. When the biopsy sides of the patients were analysed; 88% (n=123) of the biopsies were performed from the right lung. It was found that 57.2% (n=79) of the patients had an FEV1 percentage of 80% and above, while 63% (n=87) had an FVC percentage below 80%. The mean duration of hospitalisation in the postoperative period was 5.9±3.62 days. It was found that 62.9% (n=88) of the patients had a hospitalisation period of 5 days or less. At least one postoperative complication was observed in 22.1% (n=31) of the patients. The most common complications were prolonged air leakage 6.4% (n=9), pneumonia 7.1% (n=10), dyspnoea 5% (n=7). There were also 3 (2.1%) mortalities. There was no significant correlation between the gender, age, body mass index, smoking status, comorbidities, pathological diagnosis, type of operation, biopsy side and complication development. FEV1 and FVC values were significantly higher in patients who did not develop complications than in patients who developed complications ( p= 0.018, p=0.023). The duration of hospitalisation was significantly higher in patients with complications than in patients without complications ( p= 0,000). Conclusion: ILD is a broad spectrum and complex disease group. The process from diagnosis to treatment planning is difficult and may leave clinicians helpless in terms of getting results. Diagnosis usually requires a multidisciplinary approach. In case of clinical and radiological failure to make a diagnosis, there are serious difficulties even in making a pathological diagnosis by lung biopsy, which is considered as a last resort. Considering that parenchymal involvement is common in ILD, lung biopsy carries the risk of serious complications in the postoperative period. Further studies on this subject are needed. Keywords: Interstitial lung diseases, Lung biopsy, Postoperative complications