TITLE:
Evaluation of Safety and Diagnostic Accuracy of Video-Assisted Thoracoscopic Biopsy in Patients with Suspected Pulmonary Metastases
AUTHORS:
Hamdy Dosoky Elayouty, Nermeen Ali Tawfik Khedr, Mohamed Samy Hamed, Hassan Salah Hassan, Abdulkader Mohamed Bayazid, Ahmed Hamdy Elayouty
KEYWORDS:
Thoracoscopic Pulmonary Biopsy, Immunophenotyping, Immunotherapy in Metastatic Lung Disease, Postoperative Complications of Thoracoscopic Pulmonary Biopsy
JOURNAL NAME:
Open Journal of Thoracic Surgery,
Vol.16 No.2,
June
30,
2026
ABSTRACT: Background: The incidence of thoracic metastatic disease is increasing. This study aimed to evaluate the diagnostic effectiveness and complication rate of thoracoscopic pulmonary biopsy and evaluate the impact of the biopsy results on subsequent treatment decisions. Methods: Our prospective single-cohort diagnostic accuracy study included patients who had thoracic metastatic disease and underwent uniport thoracoscopic pulmonary biopsy at our centers between January 2022 and June 2024. Demographic data, preoperative clinical evaluation, positron emission tomography/computed tomography (PET/CT) findings, operative, pathological and postoperative data were collected and analyzed. Patient epidemiological and clinical features were expressed as range, mean ± standard deviation, median value and percentage. Continuous variables were expressed as mean ± SD or median (IQR), and categorical variables as percentages. P value was considered significant if 0.05. Results: This study included 680 (48.5%) males and 720 (51.5%) females, median age of 64 years (interquartile range: 55 - 71 years). The mean preoperative disease-free interval was 23 ± 4.5 months. The distribution of primary cancer origins among patients with pulmonary metastases was highly statistically significant (P Conclusions: Uniport thoracoscopic lung biopsy is a safe, minimally invasive, and highly accurate procedure guided by PET/CT findings and frozen section in selected cases. This provides adequate tissue for definitive histopathological and immunophenotypic evaluation, guiding proper multidisciplinary oncological treatment.