Utilization and Safety of Percutaneous Lung Biopsy: A 10-Year Nationwide Population-Based Study

Chen, Chun-Ku; Chang, Hsiao-Ting; Chen, Yu‐Chun; Chiang, Shu Chiung; Chou, Hsiao-Ping; Chen, Tzeng Ji

doi:10.3390/ijerph16081316

Cited by 7 publications

(9 citation statements)

References 19 publications

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“…A previous Taiwanese study estimated the rate of major complications after percutaneous lung biopsy to be 0.1% to 1.6% [ 6 ], whereas the downstream major complication rate for needle biopsy among all age groups was 1.8% (95% CI: 0.4% to 3.2%) after adjustment for the baseline rate in our study (see Supplementary Table S2 ). This inconformity might be explained by some differences in study design.…”

Section: Discussionmentioning

confidence: 59%

“…One of the drawbacks of lung cancer screening is its high rate of false-positive results [ 1 , 5 ], which brings about unnecessary invasive lung procedures, including thoracic surgery, bronchoscopy, and needle biopsy. In Taiwan, for example, a 6.1-fold increase of CT-guided needle biopsies was noted within 10 years [ 6 ]. As a result, an increase in complications has been observed, resulting in additional harm and increasing the healthcare expenditure.…”

Section: Introductionmentioning

confidence: 99%

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Downstream Complications and Healthcare Expenditure after Invasive Procedures for Lung Lesions in Taiwan

Yang

Lai

Kuo

et al. 2021

IJERPH

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This study aimed to estimate the downstream complications and healthcare expenditure after invasive procedures for lung lesions, which in turn could be used for future cost-effectiveness analyses of lung cancer screening in Taiwan. We interlinked the Taiwan National Beneficiary Registry with the National Health Insurance Reimbursement databases to identify non-lung cancer individuals aged 50–80 years who underwent invasive lung procedures within one month after non-contrast chest computed tomography between 2014 and 2016. We directly matched one individual with 10 controls by age, gender, calendar year, residence area, comorbidities, and the past one-year healthcare expenditure to calculate incremental one-month complication rates and attributable costs. A total of 5805 individuals who underwent invasive lung procedures were identified and matched with 58,050 controls. The incremental one-month complication rates were 13.4% (95% CI: 10.9% to 15.8%), 10.7% (95% CI: 9.2% to 12.1%), and 4.4% (95% CI: 2.0% to 6.7%) for thoracic surgery, bronchoscopy, and needle biopsy, respectively. The incremental one-month healthcare expenditure for minor, intermediate, and major complications were NT$1493 (95% CI: NT$-3107 to NT$6092), NT$18,422 (95% CI: NT$13,755 to NT$23,089), and NT$58,021 (95% CI: NT$46,114 to NT$69,929), respectively. Individuals aged 60–64 years incurred the highest incremental costs. Downstream complications and the healthcare expenditure after invasive procedures for lung lesions would be substantial for non-lung cancer individuals 50–80 years of age. These estimates could be used in modeling the cost-effectiveness of the national lung screening program in Taiwan.

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Section: Discussionmentioning

confidence: 59%

Section: Introductionmentioning

confidence: 99%

Downstream Complications and Healthcare Expenditure after Invasive Procedures for Lung Lesions in Taiwan

Yang

Lai

Kuo

et al. 2021

IJERPH

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“…Moreover, the therapeutic choice for patients with LBS-CC is debated [88]; therefore the patients enrolled in the current study were mainly based on shared decision making, which directly influenced the sample size, resulting in an insufficient power to properly compare PFS and OS between the two types of surgery after NACT. Second, based on the same reason shown above, an additional cost is required for receiving robotic surgery, which is not covered by the National Insurance Health Care System in Taiwan [89,90,91,92,93,94], and the risk of selection bias could not be totally avoided, contributing to a significantly greater number of patients with FIGO stage IIB in the robotic group. This is a well-known limitation of the retrospective design.…”

Section: Discussionmentioning

confidence: 99%

Radical Hysterectomy After Neoadjuvant Chemotherapy for Locally Bulky-Size Cervical Cancer: A Retrospective Comparative Analysis between the Robotic and Abdominal Approaches

Liu

Lee

Lin

et al. 2019

IJERPH

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Radical hysterectomy (RH) is the standard treatment for early stage cervical cancer, but the surgical approach for locally bulky-size cervical cancer (LBS-CC) is still unclear. We retrospectively compared the outcomes of women with LBS-CC treated with neoadjuvant chemotherapy (NACT) and subsequent RH between the robotic (R-RH) and abdominal approaches (A-RH). Between 2012 and 2014, 39 women with LBS-CC FIGO (International Federation of Gynecology and Obstetrics) stage IB2–IIB were treated with NACT-R-RH (n = 18) or NACT-A-RH (n = 21). Surgical parameters and prognosis were compared. Patient characteristics were not significantly different between the groups, but the NACT-R-RH group had significantly more patients with FIGO stage IIB disease, received multi-agent-based NACT, and had a lower percentage of deep stromal invasion than the NACT-A-RH group. After NACT-R-RH, surgical parameters were better, but survival outcomes, such as disease-free survival (DFS) and overall survival (OS), were significantly worse. On multivariate analysis, FIGO stage IIB contributed to worse DFS (p = 0.003) and worse OS (p = 0.012) in the NACT-A-RH group. Women with LBS-CC treated with NACT-R-RH have better perioperative outcomes but poorer survival outcomes compared with those treated with NACT-A-RH. Thus, patients with FIGO stage IIB LBS-CC disease might not be suitable for surgery after multi-agent-based NACT.

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“…Computed tomography (CT)-guided or ultrasound-guided percutaneous lung biopsy has a high diagnostic rate for peripheral pulmonary lesions, but often leads to complications. Similar to the field of adult pulmonology, the most common complications of percutaneous lung biopsy include pneumothorax, with reported rates up to 62%, and hemorrhage, with reported rates up to 56% ( 1 , 2 ).…”

Section: Introductionmentioning

confidence: 99%

“…The methods used to biopsy peripheral pulmonary lesions in children include percutaneous lung biopsy, thoracoscopic lung biopsy, and bronchoscopic lung biopsy. Among these methods, bronchoscopic biopsy causes the least complications, but conventional bronchoscopy has an extremely low diagnostic rate for peripheral pulmonary lesions ( 2 , 3 ). Due to the lack of effective guidance methods, the diagnostic efficacy of transbronchial lung biopsy for solitary peripheral pulmonary diseases is still limited.…”

Section: Introductionmentioning

confidence: 99%

Pilot study of archimedes virtual bronchoscopic navigation system-guided biopsy to diagnose lung nodules in children

Yang

Turgon²,

Pan³

et al. 2023

Front. Pediatr.

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BackgroundPeripheral pulmonary lesions are uncommon in children. Bronchoscopy is a minimal invasive method to obtain a diagnostic lung biopsy. However, due to the lack of effective guidance methods, the diagnostic efficacy of transbronchial lung biopsy for peripheral solitary pulmonary diseases is still limited.Research questionIs the Archimedes virtual bronchoscopic navigation system safe and effective for the diagnosis of peripheral pulmonary lesions in children?Study design and methodsThis pilot study retrospectively analyzed the clinical features, radiological characteristics, operation processes, intra-and postoperative complications, and pathological results of five children who underwent Archimedes-guided biopsy of peripheral pulmonary lesions in Beijing Children's Hospital from May 2021 to May 2022.ResultsThe cohort comprised five children (all males) with age of 7.1–15.8 years. A guide sheath was inserted through the bronchoscope under the guidance of Archimedes combined with radial endobronchial ultrasound to complete the biopsy under general anesthesia. The fused fluoroscopy technique was used to reconfirm the location of the forceps prior to biopsy in all children. The forceps reached the lesion under the guidance of the navigation and the samples were collected successfully in all children. Pathological examination of the biopsy specimens showed Epstein-Barr virus infection-related lymphoproliferative disease in one child, pulmonary metastasis of rhabdomyosarcoma in one child, and pulmonary vasculitis in one child; high-throughput sequencing of the biopsy tissue sample identified Mycobacterium tuberculosis (sequence no. 80) in one child and Aspergillus (sequence no. 40) in another child. All five children tolerated the biopsy procedure without developing postoperative complications, such as pneumothorax and hemoptysis.InterpretationArchimedes-guided bronchoscopic lung biopsy is a feasible and efficient way to diagnose peripheral pulmonary lesions in children with manageable complications.

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Utilization and Safety of Percutaneous Lung Biopsy: A 10-Year Nationwide Population-Based Study

Cited by 7 publications

References 19 publications

Downstream Complications and Healthcare Expenditure after Invasive Procedures for Lung Lesions in Taiwan

Downstream Complications and Healthcare Expenditure after Invasive Procedures for Lung Lesions in Taiwan

Radical Hysterectomy After Neoadjuvant Chemotherapy for Locally Bulky-Size Cervical Cancer: A Retrospective Comparative Analysis between the Robotic and Abdominal Approaches

Pilot study of archimedes virtual bronchoscopic navigation system-guided biopsy to diagnose lung nodules in children

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