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DOI: 10.1055/s-0035-1551040
Pneumothorax Complicating Coaxial and Non-Coaxial CT-Guided Lung Biopsy: Comparative Analysis
Zielsetzung:
To assess the scope and determining risk factors related to the development of pneumothorax throughout CT-guided biopsy of pulmonary lesions in coaxial and non-coaxial techniques and the outcome of its management.
Material und Methodik:
The study included CT-guided percutaneous lung biopsies in 650 consecutive patients (407 males, 243 females; mean age 54.6 years, SD: 5.2) in a retrospective design. Patients were classified according to lung biopsy technique into coaxial group (318 lesions) and non-coaxial group (332 lesions).
Ergebnisse:
The incidence of pneumothorax was less in the non-coaxial group(23.2%) than the coaxial group(27%).However,the difference in incidence between both groups was statistically insignificant(p = 0.14).Significant risk factors for the development of pneumothorax were emphysema, crossing pulmonary fissure in the needle access (p value 0.005 in non-coaxial group and 0.001 in coaxial group), small size of the lesion less than 2 cm (p value of 0.02 in both groups),basal or middle lung region location of the lesion(p = 0.003 and < 0.001 in non-coaxial and coaxial groups respectively),and increased needle track path within the lung tissue of more than 2.5 cm.Simultaneous incidence of pneumothorax and pulmonary hemorrhage was 27.3% (21/77) in non-coaxial group and in 30.2% (26/86) in coaxial group. Conservative management was sufficient for treatment of 91out of 101patients of pneumothorax in both groups (90.1%).
Schlussfolgerungen:
Pneumothorax complicating CT-guided core biopsy of pulmonary lesions, showed insignificant difference between coaxial and non-coaxial techniques. However both techniques have the same significant risk factors including small and basal lesions, increased lesion's depth from pleural surface, increased length of aerated lung parenchyma crossed by biopsy needle and passing through pulmonary fissures in the needle tract.