What is the role of surgical lung biopsy in interstitial lung disease?

Abstract

Opdivo. The battle cry of Primum Non Nocere rings loud when small peripheral metastases are growing rapidly on serial CT imaging in fit healthy patients. A quick VATS Wedge Resection through a single port or two with an overnight stay is now the norm, with some surgeons now performing such surgery on awake patients as daystay cases. Our own unpublished series of 477 operations recorded only two 30-day mortalities (0.46%) with very low complication rates. But is the absence of evidence of benefit equal to evidence of absence of benefit? And have we missed our opportunity in CRC to prove the benefit of surgery in a highly selected group of the truly oligometastatic with substantial randomized evidence? I suspect that our place in the treatment of metastatic CRC will diminish in time unless we quickly unlock the secrets of its quirky biological nature. References