Key points about lung biopsy in children
- a lung biopsy involves taking a small sample of lung tissue
- a lung biopsy helps doctors diagnose and manage medical conditions
- doctors use keyhole surgery called VATS for most lung biopsies
- your child will have a general anaesthetic, so they will be asleep during the procedure
What is a lung biopsy?
A lung biopsy involves taking a small sample of lung tissue. Doctors use keyhole surgery called VATS for most lung biopsies. VATS stands for Video Assisted Thoracoscopic Surgery. Your child will have an anaesthetic to put them to sleep during the procedure.
A specialist doctor will do the lung biopsy at the hospital. The doctor sends the sample of lung tissue to the lab for a closer look. This helps doctors understand what is causing problems in your child’s lungs.
This illustration shows a lung biopsy in a child. The child lies on their side, and the close-up shows a small sample of lung tissue being taken using keyhole surgery.
Source: KidsHealth
transcribeTranscript
The illustration shows a boy child lying on their left side in a hospital bed, wearing a grey T-shirt and shorts. Their right leg is bent, and their arms are extended above their head. A dashed line points from a circle on the child’s right upper chest under their right arm to an enlarged circular cross-section of the chest.
In the cross-section, forceps and a camera are shown inserted between the ribs to reach the lung. The forceps are holding a small piece of lung tissue. The text beneath reads: ‘Lung biopsy. Taking a small sample of lung tissue using keyhole surgery.’
At the top right is the KidsHealth logo with the website: kidshealth.org.nz
Reasons for needing a lung biopsy
Scans and lung function tests give information about the health of the lungs. These happen first. A lung biopsy may help if the scans and lung function tests don’t provide enough information.
Tamariki (children) may need a lung biopsy for different reasons.
To diagnose a medical condition
A lung biopsy can help diagnose rare lung diseases. This includes conditions like interstitial lung disease and rare infections. A lung biopsy can also help doctors understand how much lung damage there is.
To monitor the lungs
Tamariki who have had a lung transplant need regular lung biopsies. This is to check that the transplanted lungs remain healthy.
Preparation for a lung biopsy
Fasting
Your child cannot eat for a period of time before their procedure. Check the appointment letter for when to stop eating and drinking.
What happens during a lung biopsy
Anaesthetic
Your child will have an anaesthetic to put them to sleep during the procedure. Your child may also have some local anaesthetic put into the skin. This can help numb pain sensations in the skin after they wake up from the biopsy.
Procedure
Your child’s doctor will explain which type of procedure your child needs.
VATS
The most common way to do the procedure is with your child lying on their side. The doctor will make small incisions (cuts) in the chest area. The doctor passes a tiny camera (thoracoscope) and surgical tools through these cuts. They then remove small pieces of lung tissue. The doctor will close the small cuts in the skin with stitches.
Bronchoscopy
Doctors cannot use VATS for all tamariki. In this case, your child may need a biopsy using a bronchoscope.
Flexible Bronchoscopy In Children
Open surgery
Very rarely, doctors need to do a full operation. Also called an open surgery. This involves a bigger cut between the ribs.
What happens after a lung biopsy
Recovery
After the procedure, your child will go to a recovery area where you can join them. They can start drinking fluids and then food when they feel ready.
Chest drain
The doctor will put in a chest drain at the end of the lung biopsy procedure. It will usually need to stay in for 1 to 2 days, to help the lung heal properly. Sometimes the drain will need to stay in for longer before it can come out.
Pain relief
Having a lung biopsy can make your child quite sore. The doctor will give your child regular pain relief to help manage their pain.
Intensive care unit (ICU)
Very rarely, some tamariki need extra support in the ICU for a short time after the procedure. This usually happens if tamariki were already very unwell or needed oxygen before surgery.
Possible side effects from having a lung biopsy
Most tamariki recover well from a lung biopsy.
Common side effects include:
- pain at the wound site – regular pain relief can help
- needing oxygen to help with breathing for a short time after surgery
Rare side effects include:
- coughing up a small amount of blood - less than a teaspoon
- infection around the wound
- fistula
A fistula is a small hole that forms between the lung and the inside of the chest. When this happens the lung cannot inflate properly and the chest drain has to stay in place. Tamariki who get a fistula may need another operation to close it.
Going home after a lung biopsy
The doctors need to remove the chest drain before your child can go home. Your child will also need to have their pain under control. Most tamariki need to stay in the hospital for 2 to 3 days after a lung biopsy.
Caring for your child at home after a lung biopsy
Pain relief
Your child may have some discomfort for a few days. This gets better after the removal of the chest drain. Pain also gets better with pain medicine and gentle movement. Your child’s doctor will talk to you about how to manage your child’s pain once they go home from the hospital.
Rest
Avoid rough and tumble play or sports until your child’s doctor has said it’s okay. Encourage gentle activity when your child feels ready.
Check the wound
Keep the biopsy wound area clean and dry. Keep an eye on the wound and check for signs of infection, such as redness, swelling or discharge.
Lung biopsy results
Your child's respiratory doctor will speak to you after the procedure to let you know how it went. It can take at least a week or two to get the results from the samples sent to the lab. Sometimes the samples need to go overseas for a second opinion. This means results will take longer to come back.
When to get medical help after a lung biopsy
You should contact the hospital or take your child to see a health professional if they:
- are having trouble breathing
- have pain that isn’t helped by pain medicine
- swelling, redness or discharge around the site of the wound
- have a fever (temperature over 38 degrees Celsius)
- appear unwell, or you are worried
If you have worries or your child has side effects that aren’t improving, see a health professional.
Acknowledgements
Illustrations by Dr Greta File. Property of KidsHealth.
