CT-guided transthoracic lung biopsy: Predictive factors of pneumothorax

Cruz, João; Rolo, Rui; Iglesias, Luis Palmero; Cunha, J.

doi:10.1016/j.rppneu.2014.01.009

Cited by 3 publications

(4 citation statements)

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“…Pneumothorax is the most frequent complication of CT-guided lung biopsy, ranging from 8.2% to 54.3% according to reports. [6][7][8][9] Several risk factors are considered to be related to the incidence of pneumothorax, including needle size, lesion size, lesion depth, the presence of emphysema etc. [10][11][12][13] and the rate of chest tube placement varies from 2% to 18%.…”

Section: Resultsmentioning

confidence: 99%

Efficacy of an opposite position aspiration on resolution of pneumothorax following CT-guided lung biopsy

et al. 2015

BJR

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respectively. In the other 24 patients (29.3%, 24/82), simple aspiration technique was ineffective. An opposite position (from prone to supine or vice versa) was applied, and a new biopsy puncture site was chosen for reaspiration. This procedure was successful in 22 patients but not in 2 patients who had to have a chest tube insertion. The complete and partial regression rates were 25.0% (6/24) and 66.7% (16/24), respectively. Applying the new method, the total effective rate of aspiration improved significantly from 70.7% (58/82) to 97.6% (80/82). Conclusion:The opposite position aspiration can be safe, effective and minimally invasive treatment for CT-guided lung biopsy-induced pneumothorax thus reducing the use of chest tube significantly. Advances in knowledge: (1) Opposite position aspiration can elevate the success rate of aspiration significantly (from 70.7% to 97.6% in our study); (2) this procedure is a safe, effective and minimally invasive treatment for pneumothorax caused by biopsy; and (3) opposite position aspiration is a useful technique to reduce the use of chest tube, which has clinical significance.

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Section: Resultsmentioning

confidence: 99%

Efficacy of an opposite position aspiration on resolution of pneumothorax following CT-guided lung biopsy

et al. 2015

BJR

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“…[26] However, another retrospective study (201 fine-needle aspiration biopsies and 68 core biopsies) failed to prove a significant correlation between increased risk of pneumothorax and lesion location. [9] Furthermore, univariate analysis in a study with 141 small nodules punctures showed that the risk of CPLB-induced pneumothorax was approximately 3 times higher for upper lobe tumors than for nonupper lobe tumors ( P = .036), but multivariate analysis did not reveal a significant difference. [27] One possible explanation for these discrepancies was the unbalanced baseline characteristics, for example, the clinical information of emphysema was unknown for some cohorts, but the presence of emphysema correlated with the occurrence of pneumothorax and the need for drainage.…”

Section: Discussionmentioning

confidence: 99%

“…[7] An obvious reduction in pneumothorax incidence has not occurred in the last 20 years. [8,9] Although CPLB is a widely accepted procedure with relatively few serious complications, precise planning and detailed knowledge of various aspects of the biopsy procedure is required to avoid complications. [8]…”

Section: Introductionmentioning

confidence: 99%

“…For example, Hiraki et al demonstrated that lesions in the lower lobe were one significant independent risk factor for pneumothorax in CPLB ( P < .001) [10] ; however, 2 other studies demonstrated that pneumothorax incidence showed no significant difference between different lung lobe lesions following CPLB. [9,12] Thus, whether tumor location is related to distinct occurrence and/or severity of pneumothorax should be further clarified. The present study was retrospectively conducted to analyze the complications of different lobe lesion punctures, with the aim of more efficiently decreasing the rate of pneumothorax and chest tube placement.…”

Section: Introductionmentioning

confidence: 99%

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Lobar location of lesions in computed tomography-guided lung biopsy is correlated with major pneumothorax

Yan¹,

Guo²,

Zhang³

et al. 2019

Medicine

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Pneumothorax is a common complication in computed tomography (CT)-guided percutaneous lung biopsy (CPLB). Whether the lobar location of lesions contributes to the incidence of pneumothorax should be further clarified. A total of 1452 consecutive patients who underwent CPLB between January 2010 and March 2018 were retrospectively analyzed. The incidence of pneumothorax was compared among 5 different lobe biopsies. Minor pneumothorax was defined as pneumothorax without chest tube placement and major pneumothorax was defined as pneumothorax with chest tube placement. The positive diagnosis rate of pathology for this cohort was approximately 84%, with 22.5% (326/1452) of the patients experiencing pneumothorax. The rates of pneumothorax were 19.5%, 24.5%, 33.9%, 21.4%, and 23.9% for the right upper lobe, right lower lobe, right middle lobe, left upper lobe, and left lower lobe, respectively ( P = .09). Chest tube placement was necessary in 19.0% (62/326) of the patients with pneumothorax. The rates of major pneumothorax were 5.3%, 2.6%, 10.2%, 4.7%, and 2.6% for the right upper lobe, right lower lobe, right middle lobe, left upper lobe, and left lower lobe biopsies, respectively ( P = .02). This result was further confirmed by the propensity score-matching method. Moreover, 8.7% (127/1452) of the patients experienced puncture of fissure, the rates of which were 13.5%, 5%, 10.2%, 9.1%, and 4.3% for the right upper lobe, right lower lobe, right middle lobe, left upper lobe, and left lower lobe, respectively ( P < .001). Within the pneumothorax patient group, the rate of lobe fissure puncture (15.2%) was significantly lower in patients with minor pneumothorax than (51.6%) in those with major pneumothorax ( P < .001). Upper and middle lobe lesion biopsies show a significantly high rate of major pneumothorax, which may be due to more puncture of fissure. It is crucial to carefully distinguish the fissure around lesions and bypass it to avoid major pneumothorax.

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Complications and Risk Factors of Patients Undergoing Computed Tomography-Guided Core Needle Lung Biopsy: A Single-Center Experience

Hajjar¹,

Fetyani²,

Alqarni³

et al. 2021

Cureus

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To determine the risk factors and complications of transthoracic computed tomography (CT)-guided core needle lung biopsy. MethodsThis is a retrospective study of 124 patients who underwent CT-guided core lung biopsy in King Khalid University Hospital (KKUH), Riyadh. This retrospective study was conducted between January 2016 and January 2020. Patient data were collected using a standardized data form that was entered into an Excel sheet in accordance with the variables. The Statistical Package for the Social Sciences software (SPSS, version 24.0 [SPSS Inc., Chicago, IL, USA]) was used to compute for the risk of complications after CT-guided core lung biopsy and perform all statistical comparisons, and the results were reported. ResultsThe overall complication rate due to CT-guided core needle biopsy was 34.7% (43) (P<0.001) of the total sample. Of the total complications, 69.76% (n = 30) had pneumothorax, 20.94% (n = 9) had hemorrhage, 6.98% (n = 3) had both pneumothorax and hemorrhage, and 2.32% (n = 1) had both air embolism and pneumothorax. Of all patients who developed pneumothorax, 20% (n = 6) required chest tube insertion. Patients with secondary chronic obstructive pulmonary disease (COPD) had a complication rate of 80% among the whole sample. Lung lesions less than 3 cm had a complication rate of 48.8% (P<0.034). The needle size showed a higher rate of complications between 20 and 18 gauge with 47.4% (n = 9) and 32.4% (n = 34), respectively. ConclusionsWe conclude that CT-guided lung biopsy is a well-established low-risk procedure that is less invasive. However, it still carries a risk of complications with some risk factors, such as small lung lesion size and secondary COPD.

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CT-guided transthoracic lung biopsy: Predictive factors of pneumothorax

Cited by 3 publications

References 4 publications

Efficacy of an opposite position aspiration on resolution of pneumothorax following CT-guided lung biopsy

Efficacy of an opposite position aspiration on resolution of pneumothorax following CT-guided lung biopsy

Lobar location of lesions in computed tomography-guided lung biopsy is correlated with major pneumothorax

Complications and Risk Factors of Patients Undergoing Computed Tomography-Guided Core Needle Lung Biopsy: A Single-Center Experience

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