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Open pleural biopsy

Definition

An open pleural biopsy is a procedure to remove and examine the tissue that lines the inside of the chest. This tissue is called the pleura.

Alternative Names

Biopsy - open pleura

How the test is performed

An open pleural biopsy is done in the hospital using general anesthesia, which means you are asleep and do not feel pain during the surgery. A tube will be placed down your throat to help you breathe.

The surgeon will make a small cut in the left or right side of the chest.

• The ribs are gently separated and a piece of tissue is taken from the chest area.
• Several pieces of tissue are usually taken, and are sent to a laboratory for examination.
• After surgery, the wound is closed with stitches.
• Your surgeon may decide to leave a small plastic tube in your chest to prevent air and fluid from building up

Today, most centers use a technique called video-assisted thoracoscopy, which uses a camera and tiny instruments to biopsy the pleural area. With this method, only two small cuts are made. There is less pain and the recovery is much faster.

How to prepare for the test

You will be asked not to eat or drink for 8 hours before the test.

How the test will feel

You will be asleep during the procedure. There will be some tenderness and pain where the surgical cut is located. Most surgeons inject a long-acting local anesthetic at the surgical cut site so that you will have very little pain afterwards.

You may have a sore throat after the test due to the breathing tube. You can ease the sore throat by eating ice chips.

Why the test is performed

This procedure is used when the surgeon needs a larger piece of tissue than can be removed with a pleural needle biopsy. The test is most often done to rule out mesothelioma.

It is also performed when there is fluid in the chest cavity, or when a direct view of the pleura and the lungs is needed.

This procedure may also be done to examine a metastatic pleural tumor.

Normal Values

The pleura will be normal.

What abnormal results mean

Abnormal findings may suggest:

• Abnormal tissue growth (neoplasms)
• Disease due to a virus, fungus, or parasite
• Mesothelioma
• Tuberculosis

What the risks are

There is a slight chance of:

• Air leak
• Excess blood loss
• Infection
• Injury to the lung
• Pneumothorax

Special considerations

References

Smythe WR, Reznik SI, Putnam JB Jr. Lung (including pulmonary embolism and thoracic outlet syndrome). In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2008:chap 59.