ABSTRACT:We conducted a retrospective study to evaluate the pulmonary biopsy specimens obtained by thoracotomy and videothoracoscopy in chronic diffuse lung disease between December 1989 and August 1995. We assessed prior clinical diagnosis, preoperative lung function, histologic diagnosis, length of hospital stay, and postoperative complications. We identified 37 patients who had undergone pulmonary biopsy. Thoracotomy was performed in 15 patients (Group A). Videothoracoscopy was performed in 22 patients (Group B). The average of tissue specimens per operation was 2.4 ± 0.96 in Group A and 2.1 ± 0.67 in Group B. The average volume of tissue specimens was 3.9 ± 4.5 cm3in Group A and 6.91 ± 5.5 cm3in Group B (p < 0.05). Histologic diagnosis was obtained in 100% of the cases. The preoperative diagnosis was in agreement with the histological findings in 65% of the cases (n = 24). The average postoperative stay was 7.9 ± 1.1 days for Group A and 5.8 ± 4.5 days for Group B (p < 0.05). Two patients in Group A and 1 in Group B had persistent air leaking. In the thoracotomy group, 1 patient died from causes unrelated to the procedure during the early postoperative period. We conclude that both techniques are suitable for the diagnosis of chronic diffuse lung disease. Videothoracoscopy has become the standard procedure in our hospital when pulmonary biopsy is required to diagnose chronic diffuse lung disease.