Risk of Pneumothorax Not Increased by Obstructive Lung Disease in Percutaneous Needle Biopsy

Anderson, C. L. V.; J, Crespo; Lie, T.

doi:10.1378/chest.105.6.1705

Cited by 55 publications

(25 citation statements)

References 17 publications

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“…This is in agreement with numerous other studies [16,24,27,28]; therefore, careful inspection of a pre-biopsy CT is recommended in order to select, where possible, the shortest and less emphysematous needle path.…”

Section: Discussionsupporting

confidence: 88%

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Ultrathin needle (25�G) aspiration lung biopsy: diagnostic accuracy and complication rates

et al. 2004

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The aim of this study was to evaluate the diagnostic accuracy and complication rate of 25-G fine-needle aspiration biopsy (FNAB) of the lung in patients with suspected malignant focal lesions and abnormal lung function. The 25-G FNAB was performed in 123 patients who underwent prebiopsy CT and pulmonary function tests. Retrospective evaluation included pulmonary function, cytology, size of the lesion, depth of location, presence of emphysema on CT, needle passes, pneumothorax and drainage. The final diagnosis (gold standard) was based on histopathology after surgical resection or follow-up and response to treatment. Sixty-one patients had normal lung function or mild impairment (group 1) and 62 had moderate or severe impairment (group 2). Pneumothorax occurred in 26 of 126 procedures (20.6%) with drainage needed in 11 (8.7%). In group 2 pneumothorax occurred in 19 of 63 procedures (30.15%) with drainage needed in 11 (17.5%). The sensitivity, specificity and diagnostic accuracy of cytology results were 93.6, 100 and 94.4%, respectively. FEV1 ( p=0.014), FEV1/FVC ( p=0.005), FEF25-75 ( p=0.001), DLCO ( p=0.013) and presence of emphysema on CT ( p<0.001) correlated with pneumothorax (Student's t test). The 25-G lung FNAB is accurate and safe in diagnosing malignancy in patients with severe lung functional abnormality. Patients with moderate to severe airway obstruction have a higher prevalence of pneumothorax than patients with mild or no functional impairment.

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Section: Discussionsupporting

confidence: 88%

“…In addition, patients with emphysema have decreased pulmonary reserve due to disruption of dilated alveoli, which subsequently prevents rapid sealing of the air leak [16]. It seems reasonable to speculate that once pneumothorax occurs in patients with obstructive pulmonary disease it is more likely to expand [24].…”

Section: Discussionmentioning

confidence: 99%

Ultrathin needle (25�G) aspiration lung biopsy: diagnostic accuracy and complication rates

et al. 2004

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“…Recently, Anderson et al (17) and Kazerooni et al (24) found that pulmonary function test results had no predictive value with regard to the frequency of pneumothorax in their studies of CTguided TNAB in 93 and 121 patients, respectively. In contrast, both Fish et al (15) and Miller et al (16) found that obstructive lung disease was a factor that affected the pneumothorax rate.…”

Section: Discussionmentioning

confidence: 99%

Transthoracic Needle Aspiration Biopsy: Variables That Affect Risk of Pneumothorax

Cox¹,

Chiles²,

McManus³

et al. 1999

Radiology

285

182

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“…The presence of COPD may be a risk factor [14•, 16, 17] as well as a smaller needlepleural angle when taking the biopsy [18,19]. Some studies suggest that the deeper the lesion being biopsied, the higher the risk of pneumothorax [17,19], but this finding is not consistent across all studies [18,20]. CT findings alone do not appear to be an accurate predictor [21].…”

Section: Iatrogenic Pneumothoraxmentioning

confidence: 99%

“…The majority will resolve spontaneously by observation alone and in those who require an intervention, simple aspiration is usually sufficient [6]. A small proportion of patients may require chest tube drainage, and this is more likely in patients with underlying COPD [20].…”

Section: Iatrogenic Pneumothoraxmentioning

confidence: 99%

Common iatrogenic pleural complications

Dunscombe

Maskell

2012

Curr Respir Care Rep

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All invasive pleural procedures have the potential to cause harm. Complications from pleural procedures include empyema, intercostal artery laceration, hemothorax, and pneumothorax as well as other organ puncture. Many of these complications will be life threatening and will increase morbidity and hospital length of stay. An understanding of iatrogenic pleural disease helps clinicians to appreciate how these risks can be minimized and complications managed promptly and effectively. This review systematically evaluates the current evidence and guidelines regarding iatrogenic pleural complications and their management. Whilst impossible to eliminate procedural risk entirely, complications will be reduced to a minimum by ensuring adequate medical training, use of pleural ultrasound, and adherence to guidelines and standard operating procedures (SOPs).

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Risk of Pneumothorax Not Increased by Obstructive Lung Disease in Percutaneous Needle Biopsy

Cited by 55 publications

References 17 publications

Ultrathin needle (25�G) aspiration lung biopsy: diagnostic accuracy and complication rates

Ultrathin needle (25�G) aspiration lung biopsy: diagnostic accuracy and complication rates

Transthoracic Needle Aspiration Biopsy: Variables That Affect Risk of Pneumothorax

Common iatrogenic pleural complications

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