Original article: general thoracicOpen-lung biopsy guides therapy in children
Section snippets
Material and methods
We retrospectively reviewed 64 biopsies in 58 patients performed by a single surgeon from 1976 through the first 6 months of 1996 at the University of Minnesota Hospitals. Cases were identified by a private office file system checked against an independent computer search of ICD-9 codes by the hospital medical records department. Included in this study were all patients less than 21 years of age who underwent open-lung biopsy for diagnostic purposes. This includes both patients with congenital
Demographics
Sixty-four open-lung biopsies were performed on 58 patients between 1976 and 1996. Twenty-three of the patients (40%) were female and 35 were male. The ages of the patients ranged between 1 day and 21 years, median 3.7 years.
There were three main indications for open-lung biopsy in this group: 46 biopsies (72%) were to diagnose pulmonary parenchymal disease, 8 (12%) were to histologically grade the vasculopathy of pulmonary hypertension, and 10 (16%) were in patients with a combined clinical
Comment
Open-lung biopsy is an uncommon diagnostic procedure in the pediatric age group. Our goal was to quantify the anticipated risk and benefit of open-lung biopsy in subgroups of children by using our retrospective cohort. The specific risk of death within 30 days and the specific benefit of a definitive diagnosis were analyzed as a function of clinical variables in order to advise future patients and their families considering this operation. These data are now available in Table 2, Table 3. Using
Acknowledgements
The authors thank Cathy Marquardt for her assistance in the accumulation of medical records. Also, we thank Douglas Baldwin, MD, and Mary Macauley for their assistance in the preparation of the manuscript and scientific presentation.
References (23)
- et al.
Interstitial pneumonitis in the immunologically suppressed childan urgent surgical condition
J Ped Surg
(1977) - et al.
Open-lung biopsyits effect on therapy in the pediatric patient
Chest
(1985) - et al.
Emergency lung biopsyfriend or foe of the immunosuppressed child?
J Ped Surg
(1986) - et al.
The usefulness of open-lung biopsy in the pediatric bone marrow transplant population
J Ped Surg
(1988) - et al.
Predictive value of lung biopsy in ventricular septal defectlong-term follow-up
J Am Coll Cardiol
(1986) - et al.
The clinical value and risks of lung biopsy in children with congenital heart disease
J Thorac Cardiovasc Surg
(1990) - et al.
Pulmonary vascular disease in complete atrioventricular canal defect
Am J Cardiol
(1977) - et al.
Open biopsy for chronic diffuse infiltrative lung diseaseclinical, roentgenographic, and physiological correlations in 502 patients
Ann Thorac Surg
(1980) - et al.
Open-lung biopsy in children
Am Rev Resp Dis
(1968) - et al.
Open-lung biopsy in infants and children
Arch Surg
(1971)
Open-lung biopsy in children with diffuse lung disease
Arch Dis Child
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