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[Lung biopsy by thoracotomy. 23 cases (author's transl)].

This series of surgical lung biopsies performed for diffuse lung disease indicates the excellent tolerance of the procedure and the high diagnostic rate. It is indicated above all in the presence of bilateral reticulo-nodular radiological appearances, suggestive of focal lesions not identified by the usual means. The surgical procedure was felt to be justified on the one hand because of the time gained in reaching a precise diagnosis whilst the results of usual laboratory investigations, even the most sophisticated, remain uncertain, and secondly in view of the discovery by the method of malignant lesions which are still curable and which it would have been impossible to identify otherwise, except by awaiting the development of more accessible lesions. Whilst percutaneous needle biopsy found favour amongst many, it would now seem to have been virtually abandoned, particular in France, in view of its risks and it's poor diagnostic rate. By contrast, open surgical biopsy provides in all cases not only lung but also pleural and mediastinal tissue. Its risks are confined to those of any surgical procedure under general anaesthesia, but appear to be sufficiently slight (mortality of 0,5 to 2%) that the technique may be used successfully in intensive care units to obtain a diagnosis in cases of certain types of respiratory distress.