Complications of invasive methods diagnosis of pulmonary dissemination syndrome, their prevention and treatment

Abstract

Objective — to study the possible complications that arise when using invasive methods for the diagnosis of pulmonary dissemination syndrome, to develop measures aimed at their prevention and treatment. Materials and methods. Data from 216 patients who used invasive methods to diagnose pulmonary dissemination syndrome were analyzed. Patients were divided into 3 groups, depending on the type of biopsy: Group I — 143 patients who underwent VATS lung biopsy, Group II — 64 patients who underwent endobronchial ultrasound transbronchial biopsy lungs (EBUS TBBL); Group III — 9 patients who underwent open biopsy. Complications in I — 12 (8.4 %), II — 5 (7.8 %), III — 2 (22.2 %), total — 19 (8.8 %). These were lung tear, wound suppuration, disease progression, pneumothorax, hemoptysis, respiratory failure, intrapleural hemorrhage. Results and discussion. Based on the obtained data, we have proposed methods of prevention of complications: radiography of the thoracic cavity in the first day after biopsy; correction of antiplatelet therapy; careful selection of patients for biopsy taking into account age, concomitant pathology, taking drugs, history.Conclusions. Lung biopsy for pulmonary dissemination syndrome is a safe type of diagnosis with a low level of complications — 8.8 %.The least traumatic method is transbronchial lung biopsy under ultrasound control.If it is impossible to perform a transbronchial lung biopsy, or if the obtained material is uninformative, the next step is to use a video­assisted lung biopsy.An open biopsy should be considered last and only under strict indications.It is important to choose the right method of biopsy, taking into account age, history, drugs.