Artigo Original/Original Article
Doenças pulmonares intersticiais: Acuidade diagnóstica e riscos da biópsia pulmonar cirúrgica
Interstitial lung disease: Diagnostic accuracy and safety of surgical lung biopsy
Miguel Guerra1,
, José António Miranda1, Francisco Leal1, Luís Vouga1
Corresponding author
migueldavidguerra@yahoo.com
Correspondência/Correspondence to: Miguel Guerra, Serviço de Cirurgia Cardiotorácica, Centro Hospitalar de Vila Nova de Gaia/Espinho, Rua Conceição Fernandes, 4434-502 Vila Nova de Gaia, Porto, Portugal, Tel: (+351) 227865100, Tlm: (+351) 933734217, Fax: (+351) 227865170.
Correspondência/Correspondence to: Miguel Guerra, Serviço de Cirurgia Cardiotorácica, Centro Hospitalar de Vila Nova de Gaia/Espinho, Rua Conceição Fernandes, 4434-502 Vila Nova de Gaia, Porto, Portugal, Tel: (+351) 227865100, Tlm: (+351) 933734217, Fax: (+351) 227865170.
1 Serviço de Cirurgia Cardiotorácica/Cardiothoracic Surgery Unit Centro Hospitalar de Vila Nova de Gaia/Espinho, Porto, Portugal
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"apellidos" => "Bugalho de Almeida" ] ] ] ] ] "idiomaDefecto" => "pt" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0873215915301434?idApp=UINPBA00004E" "url" => "/08732159/0000001500000003/v1_201509151500/S0873215915301434/v1_201509151500/pt/main.assets" ] "pt" => array:15 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Artigo Original/Original Article</span>" "titulo" => "Doenças pulmonares intersticiais: Acuidade diagnóstica e riscos da biópsia pulmonar cirúrgica" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "433" "paginaFinal" => "442" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Miguel Guerra, José António Miranda, Francisco Leal, Luís Vouga" "autores" => array:4 [ 0 => array:4 [ "nombre" => "Miguel" "apellidos" => "Guerra" "email" => array:1 [ 0 => "migueldavidguerra@yahoo.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">1</span>" "identificador" => "af0005" ] 1 => array:2 [ "etiqueta" => "*" "identificador" => "cr0005" ] ] ] 1 => array:3 [ "nombre" => "José António" "apellidos" => "Miranda" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">1</span>" "identificador" => "af0005" ] ] ] 2 => array:3 [ "nombre" => "Francisco" "apellidos" => "Leal" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">1</span>" "identificador" => "af0005" ] ] ] 3 => array:3 [ "nombre" => "Luís" "apellidos" => "Vouga" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">1</span>" "identificador" => "af0005" ] ] ] ] "afiliaciones" => array:1 [ 0 => array:3 [ "entidad" => "Serviço de Cirurgia Cardiotorácica/<span class="elsevierStyleItalic">Cardiothoracic Surgery Unit</span> Centro Hospitalar de Vila Nova de Gaia/Espinho, Porto, Portugal" "etiqueta" => "1" "identificador" => "af0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cr0005" "etiqueta" => "*" "correspondencia" => "<span class="elsevierStyleBold">Correspondência</span>/<span class="elsevierStyleItalic"><span class="elsevierStyleBold">Correspondence to:</span></span> Miguel Guerra, Serviço de Cirurgia Cardiotorácica, Centro Hospitalar de Vila Nova de Gaia/Espinho, Rua Conceição Fernandes, 4434-502 Vila Nova de Gaia, Porto, Portugal, Tel: (+<span class="elsevierStyleHsp" style=""></span>351) 227865100, Tlm: (+<span class="elsevierStyleHsp" style=""></span>351) 933734217, Fax: (+<span class="elsevierStyleHsp" style=""></span>351) 227865170." ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Interstitial lung disease: Diagnostic accuracy and safety of surgical lung biopsy" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2008-06-20" "fechaAceptado" => "2008-12-30" "PalabrasClave" => array:2 [ "pt" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palavras-chave" "identificador" => "xpalclavsec570262" "palabras" => array:5 [ 0 => "Doença pulmonar intersticial" 1 => "biópsia pulmonar cirúrgica" 2 => "acuidade diagnóstica" 3 => "complicações pós-operatórias" 4 => "morbimortalidade" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key-words" "identificador" => "xpalclavsec570263" "palabras" => array:5 [ 0 => "Interstitial lung disease" 1 => "surgical lung biopsy" 2 => "diagnostic accuracy" 3 => "postoperative complications" 4 => "morbimortality" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "pt" => array:2 [ "titulo" => "Resumo" "resumen" => "<span id="as0005" class="elsevierStyleSection elsevierViewall"><p id="sp0005" class="elsevierStyleSimplePara elsevierViewall">Os autores descrevem a sua casuística de biópsias pulmonares cirúrgicas em doentes com doença pulmonar intersticial, de forma a determinar a acuidade diagnóstica, os riscos e a morbimortalidade associados ao procedimento. Entre Janeiro de 1998 e De-zembro de 2007, 53 doentes (idade média de 47,2±13 anos) foram referenciados para a realização de biópsia pulmonar cirúrgica, dos quais 22 eram mulheres (41,5%). As biópsias pulmonares foram realizadas quer por videotoracoscopia (37 doentes, 69,8%), quer por minitoracotomia (16 doentes, 30,2%). Foi escolhido o pulmão direito para biopsar em 88,7% dos casos. Registaram-se complicações pós-operatórias em 5 doentes (9,4%): fuga aérea prolongada em 3 doentes (5,7%), persistência de loca de pneumotórax num doente (1,9%) e hemorragia com necessidade de revisão de hemostase noutro doente (1,9%). Ocor-reu um óbito de causa desconhecida num doente sem risco acrescido. A duração média da drenagem foi de 4,4±3 dias e o tempo de internamento médio de 5,5±4 dias. O diagnóstico histológico definitivo foi conseguido em 50 doentes, registando-se uma acuidade diagnóstica de 94,3%. Em conclusão, o potencial benefício de um diagnóstico histopatológico conclusivo através de uma biópsia pulmonar cirúrgica deve ser balanceado com os riscos associados ao procedimento cirúrgico, especialmente para aqueles doentes com disfunção cardiopulmonar severa.</p><p id="sp0010" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">Rev Port Pneumol 2009; XV (3): 433-442</span></p></span>" ] "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<span id="as0010" class="elsevierStyleSection elsevierViewall"><p id="sp0015" class="elsevierStyleSimplePara elsevierViewall">This study reports our experience, diagnostic accuracy and safety of surgical lung biopsy in patients with interstitial lung diseases. From January 1998 – December 2007 surgical lung biopsy was performed in 53 patients (22 female [41.5%]; age 47.2<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>13<span class="elsevierStyleHsp" style=""></span>years). A total of 37 patients (69.8%) underwent videothoracoscopic lung biopsy and minithoracotomy was performed in 16 patients (30.2%). Right lung was the choice in 47 patients (88.7%). Postoperative complications were rare (9.4%) and included three prolonged air leaks (5.7%), one pneumothorax re-quiring a chest drain (1.9%), and one haemothorax requiring reoperation (1.9%). One patient died of cardiac arrest of unknown cause. Average chest tube duration was 4.4<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>3<span class="elsevierStyleHsp" style=""></span>days and average hospital stay 5.4<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>4<span class="elsevierStyleHsp" style=""></span>days. Lung biopsy contributed to the diagnosis in 50 patients (94.3%). In conclusion, the potential benefits of diagnostic surgical lung biopsy must be considered against the risks of the procedure especially in patients with severe cardiopulmonary dys-function.</p><p id="sp0020" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">Rev Port Pneumol 2009; XV (3): 433-442</span></p></span>" ] ] "lecturaRecomendada" => array:1 [ 0 => array:3 [ "vista" => "all" "titulo" => "<span class="elsevierStyleSectionTitle" id="st0025">Bibliografia/Bibliography</span>" "seccion" => array:1 [ 0 => array:2 [ "vista" => "all" "bibliografiaReferencia" => array:24 [ 0 => array:3 [ "identificador" => "bb0005" "etiqueta" => "1." 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Article information
ISSN: 08732159Original language: Portuguese
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| 2018 December | 11 | 8 | 19 |
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| 2016 June | 3 | 0 | 3 |
| 2016 May | 1 | 0 | 1 |
| 2016 April | 2 | 1 | 3 |
| 2016 March | 1 | 3 | 4 |
| 2016 February | 5 | 5 | 10 |
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| 2015 December | 6 | 2 | 8 |
| 2015 November | 5 | 1 | 6 |
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