Utility of open surgical lung biopsy in children

Introduction: Open lung biopsy (OLB) is commonly used to obtain a definitive histological diagnosis in children with respiratory disorders. This allows correct treatment pathways to be followed and guides discussions surrounding prognosis. Our aim was to determine if OLB is useful in obtaining a conclusive diagnosis in a child with complex respiratory disease.

Materials and methods: In total, 179 OLB episodes were identified in children under 18 years from 2006 to 2016. Biopsies confirming congenital thoracic malformations or pulmonary metastatic disease were excluded.

Results: 42 patients had 44 episodes of OLB in the period studied. A definitive histological diagnosis was reached in 35 (79%) cases. There were no deaths directly attributable to OLB surgery.

Conclusion: OLB contributed substantially in obtaining a definitive diagnosis for our patient population, no increase in mortality. It allowed targeted treatment and provided valuable prognostic information on the likely progression of the disease so families could plan for palliation where appropriate.