Minithoracotomy Versus Thoracoscopic Pulmonary Wedge Resection in Interstitial Lung Diseases

Lung biopsy is the gold standard for definitive diagnosis of interstitial lung diseases (ILD). A biopsy is usually performed by non-anatomical wedge resection as an open or thoracoscopy approach. We aimed to compare minithoracotomy approach with thoracoscopy in ILD. Overall, 43 patients with ILD who had referred to Imam Khomeini Hospital for open lung biopsy from 2008 to 2013, were enrolled, and their clinical findings, chest radiography, high resolution computed tomography (HRCT) and spirometry were considered before referral. A total of 43 (12 males and 31 females, with mean age of 41.90 ± 8.64 years) patients underwent minithoracotomy for open lung biopsy. Minithoracotomy mortality rate was 0% compared to the 0 - 5.2% reported for thoracoscopy. The mean hospital stay for minithoracotomy was 2.3 ± 0.97 days compared to 4.9 ± 1.53 days reported for thoracoscopy (P < 0.05). The complication rate was 0.05% and mean length of operation time was 35 minutes. Minithoracotomy had fewer complications, shorter length of operation and no operative mortality compared to thoracoscopy. Minithoracotomy may be the method of choice even in patients with severe shortness of breath.