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Investigation of postoperative pulmonary complications in patients undergoing surgical lung biopsy with a preliminary diagnosis of interstitial lung disease
1Department of Thoracic Surgery, Akdeniz University Medical Faculty, Antalya, Türkiye
2Department of Respiratory Diseases, Akdeniz University Medical Faculty, Antalya, Türkiye
Eurasian Journal of Pulmonology - DOI: 10.14744/ejp.2025.18928
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Abstract


BACKGROUND AND AIM: Interstitial lung disease (ILD) includes a spectrum of lung disorders with various causes, pathological changes, treatment strategies, and prognoses. Lung biopsy is often crucial for diagnosing ILD subtypes, especially in complex cases. However, biopsy procedures carry significant risks due to potential postoperative complications. This study aimed to assess the rate and types of postoperative complications in ILD patients following lung biopsy and to examine their relationship with patient demographics, lung function, and comorbidities.


METHODS: We conducted a retrospective, cross-sectional review of ILD patients who underwent surgical lung biopsy at Akdeniz University Hospital between January 1, 2017 and December 31, 2022. Data collected included demographics, comorbidities, pulmonary function tests (forced expiratory volume in one second [FEV1] and forced vital capacity [FVC]), type of surgery (video-assisted thoracoscopic surgery [VATS] or thoracotomy), biopsy location, hospital stay duration, and postoperative complications (pneumonia, prolonged air leak, hypoxia, pneumothorax, subcutaneous emphysema, pleural effusion, and mortality). Statistical analyses were performed to identify factors associated with complication rates.


RESULTS: Among the 140 patients analyzed, the mean age was 56.9±11.1 years, with 50.7% female. Postoperative complications occurred in 22.1% of patients, with hypoxia, pneumonia, and prolonged air leak being the most frequent. Lower FEV1 was significantly associated with higher complication rates (p=0.018), while hospital stays longer than five days were also associated with increased complication rates (p<0.001). Sex, body mass index (BMI), and comorbidities showed no significant associations with complication rates.


CONCLUSIONS: Our findings reveal an increased risk of complications in ILD patients undergoing lung biopsy, particularly among those with lower FEV1 and longer hospital stays. These results underscore the importance of thorough preoperative evaluation and suggest that VATS may be preferable to more invasive methods for ILD diagnosis.