{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T20:06:06Z","timestamp":1785873966061,"version":"3.56.0"},"reference-count":21,"publisher":"BMJ","issue":"4","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Reg Anesth Pain Med"],"accepted":{"date-parts":[[2020,1,5]]},"published-print":{"date-parts":[[2020,4]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Interstitial lung disease (ILD) management guidelines support lung biopsy-guided therapy. However, the high mortality associated with thoracoscopic lung biopsy using general anesthesia (GA) in patients with ILD has deterred physicians from offering this procedure and adopt a diagnostic approach based on high-resolution CT. Here we report that thoracoscopy under regional anesthesia could be a safer alternative for lung biopsy and effectively guide ILD treatment.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>This was a single-center retrospective review of prospectively maintained database and consisted of patients who underwent thoracoscopic lung biopsy between March 2016 and March 2018. Patients were divided into two groups: (A) GA, and (B) regional anesthesia using monitored anesthesia care (MAC) and thoracic epidural anesthesia (TEA).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>During the study period, 44 patients underwent thoracoscopic lung biopsy. Of these, 15 underwent MAC\/TEA. There were no significant differences between the two groups with regard to pulmonary function test and clinicodemographic profile. However, operative time and hospital stay were shorter in MAC\/TEA group (32.5\u00b118.5 min vs 50.8\u00b118.4; p=0.004, 1.0\u00b11.3 days vs 10.0\u00b134.7 days; p&lt;0.001, respectively). Eight patients in the GA group, but none in the MAC\/TEA group, experienced worsening of ILD after lung biopsy (p=0.03). Additionally, one patient in the GA group died due to acute ILD worsening. No cases of MAC\/TEA group had to be converted to GA. In all cases a pathological diagnosis could be made.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Thoracoscopy using regional anesthesia might be a safer alternative to lung biopsy in patients with ILD.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/rapm-2019-100686","type":"journal-article","created":{"date-parts":[[2020,2,17]],"date-time":"2020-02-17T03:55:12Z","timestamp":1581911712000},"page":"255-259","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":11,"title":["Thoracoscopic lung biopsy under regional anesthesia for interstitial lung disease"],"prefix":"10.1136","volume":"45","author":[{"given":"Chitaru","family":"Kurihara","sequence":"first","affiliation":[{"name":"Department of Surgery, Division of Thoracic Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian","family":"Tolly","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Anesthesiology and Critical Care Medicine, Northwestern University, Chicago, Illinois, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andre","family":"DeWolf","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Anesthesiology and Critical Care Medicine, Northwestern University, Chicago, Illinois, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antoun","family":"Nader","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Anesthesiology and Critical Care Medicine, Northwestern University, Chicago, Illinois, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Thoracic Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David D","family":"Odell","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Thoracic Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela C","family":"Argento","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Pulmonary and Critical Care Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G R Scott","family":"Budinger","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Pulmonary and Critical Care Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ankit","family":"Bharat","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Thoracic Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2020,2,16]]},"reference":[{"key":"2025101112424376000_45.4.255.1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.2009-040GL"},{"key":"2025101112424376000_45.4.255.2","doi-asserted-by":"publisher","DOI":"10.2169\/internalmedicine.49.3225"},{"key":"2025101112424376000_45.4.255.3","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejcts.2007.02.035"},{"key":"2025101112424376000_45.4.255.4","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1016\/j.thorsurg.2017.06.008","article-title":"Nonintubated-Awake anesthesia for Uniportal video-assisted thoracic surgery procedures","volume":"27","author":"Zheng","year":"2017","journal-title":"Thorac Surg Clin"},{"key":"2025101112424376000_45.4.255.5","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2012.10.043"},{"key":"2025101112424376000_45.4.255.6","doi-asserted-by":"crossref","first-page":"S364","DOI":"10.21037\/jtd.2016.04.39","article-title":"Non-intubated video-assisted thoracic surgery: where does evidence stand?","volume":"8","author":"Tacconi","year":"2016","journal-title":"J Thorac Dis"},{"key":"2025101112424376000_45.4.255.7","doi-asserted-by":"crossref","first-page":"S2664","DOI":"10.21037\/jtd.2018.06.48","article-title":"Tubeless major pulmonary resections","volume":"10","author":"Lirio","year":"2018","journal-title":"J Thorac Dis"},{"key":"2025101112424376000_45.4.255.8","doi-asserted-by":"crossref","first-page":"4236","DOI":"10.21037\/jtd.2018.06.163","article-title":"Comparison of non-intubated versus intubated video-assisted thoracoscopic lobectomy for lung cancer","volume":"10","author":"AlGhamdi","year":"2018","journal-title":"J Thorac Dis"},{"key":"2025101112424376000_45.4.255.9","first-page":"888","article-title":"VATS biopsy for undetermined interstitial lung disease under non-general anesthesia: comparison between uniportal approach under intercostal block vs. three-ports in epidural anesthesia","volume":"6","author":"Ambrogi","year":"2014","journal-title":"J Thorac Dis"},{"key":"2025101112424376000_45.4.255.10","doi-asserted-by":"publisher","DOI":"10.1111\/1759-7714.12070"},{"key":"2025101112424376000_45.4.255.11","first-page":"31","article-title":"Nonintubated thoracoscopic surgery using regional anesthesia and vagal block and targeted sedation","volume":"6","author":"Chen","year":"2014","journal-title":"J Thorac Dis"},{"key":"2025101112424376000_45.4.255.12","doi-asserted-by":"publisher","DOI":"10.1016\/j.aat.2012.08.007"},{"key":"2025101112424376000_45.4.255.13","doi-asserted-by":"crossref","first-page":"197.2","DOI":"10.1093\/ejcts\/ezw231","article-title":"Non-intubated video-assisted thoracic surgery: breaking down paradigms","volume":"51","author":"Armenta-Flores","year":"2017","journal-title":"Eur J Cardiothorac Surg"},{"key":"2025101112424376000_45.4.255.14","doi-asserted-by":"publisher","DOI":"10.1097\/ACO.0b013e32835c4ea2"},{"key":"2025101112424376000_45.4.255.15","doi-asserted-by":"publisher","DOI":"10.1213\/01.ane.0000172112.02902.77"},{"key":"2025101112424376000_45.4.255.16","doi-asserted-by":"publisher","DOI":"10.1097\/01.aco.0000192783.40021.c1"},{"key":"2025101112424376000_45.4.255.17","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0b013e3182742e75"},{"key":"2025101112424376000_45.4.255.18","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2006.10.002"},{"key":"2025101112424376000_45.4.255.19","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2009.04.002"},{"key":"2025101112424376000_45.4.255.20","first-page":"437","article-title":"Video-assisted thoracoscopic lung biopsy as a possible cause of acute interstitial pneumonia in a patient with nonspecific interstitial pneumonia","volume":"11","author":"Moore","year":"2004","journal-title":"Can Respir J"},{"key":"2025101112424376000_45.4.255.21","doi-asserted-by":"publisher","DOI":"10.1093\/ejcts\/ezv136"}],"container-title":["Regional Anesthesia &amp; Pain Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/rapm-2019-100686","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T19:42:56Z","timestamp":1760211776000},"score":1,"resource":{"primary":{"URL":"https:\/\/rapm.bmj.com\/lookup\/doi\/10.1136\/rapm-2019-100686"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,2,16]]},"references-count":21,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2020,3,19]]},"published-print":{"date-parts":[[2020,4]]}},"alternative-id":["10.1136\/rapm-2019-100686"],"URL":"https:\/\/doi.org\/10.1136\/rapm-2019-100686","relation":{},"ISSN":["1098-7339","1532-8651"],"issn-type":[{"value":"1098-7339","type":"print"},{"value":"1532-8651","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,2,16]]}}}