TY - JOUR T1 - Safety and advantages of VATS biopsy in diagnosis of interstitial lung disease JF - European Respiratory Journal JO - Eur Respir J DO - 10.1183/13993003.congress-2015.PA1518 VL - 46 IS - suppl 59 SP - PA1518 AU - Luca Bertolaccini AU - Simona Paiano AU - Carlo Pomari AU - Luca Rosario Assante AU - Andrea Viti AU - Alberto Terzi Y1 - 2015/09/01 UR - http://erj.ersjournals.com/content/46/suppl_59/PA1518.abstract N2 - Background: Differential diagnosis of Interstitial Lung Disease(ILD)is essential;role of VATS lung biopsy(VLB)is controversial.Aims/Objectives: Ascertain if VLB accuracy is superior to HRCT & role in ILD management.Methods: ILD without clear pathological diagnosis(2008–2014). Smoking statusNever[No.(%)]26 (29.89%)Former[No.(%)]42 (48.27%)Current[No.(%)]19 (21.84%)Preoperative pulmonary function testsFEV1[%,(range)]82.3 (57.3-101)DLCO/VA[%,(range)]57.9 (39.9-94.2)Results: 87 consecutive patients included.Specific pathologic diagnosis in 97.7%. HRCT identified pathologic diagnosis in 51.7%.Major complications=3.5%[ILD acute exacerbation(1),hemothorax(1),postoperative pneumonia(1)].Minor complications=5.8%.64.4% received changes in treatment.Mortality was absent.Risk factors at Cox analysis were increasing age(p<0.05) & need for preoperative supplemental O2(p<0.0001).Diagnosis of ILDPreoperative (HRCT)Postoperative (VLB)Usual interstitial pneumonia40 (45.97%)33 (37.93%)Cryptogenic organizing pneumonia04 (4.60%)Respiratory bronchiolitis-associated interstitial lung disease17 (19.54%)12 (13.80%)Lung dominant connective tissue disease09 (10.34%)Anti-neutrophil cytoplasmic autoantibody-related interstitial pneumonia03 (3.45%)Chronic hypersensitivity pneumonitis08 (9.20%)Pneumoconiosis5 (5.75%)11 (12.63%)Chronic eosinophilic pneumonia02 (2.30%)Pulmonary lymphangioleiomyomatosis1 (1.15%)1 (1.15%)Sarcoidosis5 (5.75%)2 (2.30%)Unclassifiable interstitial pneumonia19 (21.84%)2 (2.30%)Conclusions: VLB is safe,effective,and superior to diagnostic accuracy of HRCT;it is gold standard for ILD diagnosis.VLB patients should be selected following discussion in multidisciplinary team meeting. ER -