Вестник хирургии имени И.И. Грекова (Jan 2018)

TO THE QUESTION OF REASONABILITY OF LUNG BIOPSY IN PRIMARY SPONTANEOUS PNEUMOTHORAX

  • A. L. Akopov,
  • A. S. Agishev,
  • V. V. Varlamov,
  • S. D. Gorbunkov,
  • I. V. Chistyakov,
  • O. V. Lukina,
  • I. V. Dvorakovskaya

DOI
https://doi.org/10.24884/0042-4625-2014-173-1-022-025
Journal volume & issue
Vol. 173, no. 1
pp. 022 – 025

Abstract

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A biopsy of lung tissues was a conventional diagnostic method for detection of disseminated processes in the lung, which weren’t diagnosed on preoperative stage. It was used during surgical anti-relapse treatment of spontaneous pneumothorax (SP). A retrospective analysis of the results of lung parenchyma biopsy was made in 143 patients, who have been operated for SP. Basic entry criteria of the research were: the age younger than 40 years old, a presence of one episode of spontaneous pneumothorax, an absence of complaints for respiratory organs before the development of the first episode of spontaneous pneumothorax. The biopsy with following pathomorphological investigation allowed a formulation of exact variant of disseminated processes, which gave the reason for the development of spontaneous pneumothorax in 9 (6%) patients out of 143. The presence of disseminated processes in the lung was detected with multispiral CT in all these patients on preoperative stage. The study of biopsy material found out the presence of emphysema of different degree of manifestation or fibrosis sites in the rest of the patients. An analysis of presented materials allowed the conclusion, that a performance of biopsy was indicated in the case of suspicion for lung disseminated processes in patients with SP. The biopsy with the following histological study didn’t explain the reason of the development of emphysematous and fibrous changes in lung parenchyma in all other cases. At the same time, it didn’t give the option for pathogenetic treatment and it wasn’t possible to predict the following pathogenesis.

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