Aims and objectives
To investigate the efficacy of lateral patient repositioning performed immediately after accomplishing ipsilateral CT-guided lung biopsy in order to prevent the occurrence of a postinterventional pneumothorax and the need of a drainage,
after pneumothorax is still the most common complication of percutaneous CT-guided lung biopsy.
Methods and materials
The clinical records and CT images of 51 consecutive patients,
who underwent percutaneous CT-guided lung biopsy in our department,
were reviewed retrospectively.
In 23 patients,
the conventional biopsy technique was used without lateral repositioning after removal of the puncture needle (group 1).
In another 28 biopsies,
the patients lying on the CT table were turned on the ipsilateral side of the punctured lung immediately after removal of the puncture needle (group 2).
A postinterventional control CT scan was obtained in all cases,
in group 1...
Results
In group 1,
a pneumothorax after lung biopsy occurred in 9/23 patients (39%),
whereas a post-biopsy pneumothorax was observed in 8/28 patients (29%) of group 2 (p = 0.4).
In group 1,
the extent of the pneumothorax required drainage in 5/9 cases (56%).
In contrast,
pneumothorax drainage was not necessary in any of the patients in group 2,
who were turned laterally on the side of the lung biopsy immediately after removing the puncture needle (p=0.01).
Conclusion
Compared with a standard patient positioning for CT-guided lung puncture,
our preliminary data indicate a statistically non-significant tendency towards a lower incidence of post-biopsy pneumothorax,
when patients are being turned on the ipsilateral side immediately after removal of the puncture needle.
The use of the lateral repositioning technique resulted in a significantly lower need for pneumothorax drainage.
Personal information
Michels,
Peter
Klinik für Interventionelle und Diagnostische Radiologie
Evangelisches Krankenhaus Mülheim a.d.
Ruhr
[email protected]
Vockelmann,
Christel; Dr.
med.
Klinik für Interventionelle und Diagnostische Radiologie
Evangelisches Krankenhaus Mülheim a.d.
Ruhr
[email protected]
Nolte-Ernsting,
Claus; Prof.
Dr.
med.
Klinik für Interventionelle und Diagnostische Radiologie
Evangelisches Krankenhaus Mülheim a.d.
Ruhr
[email protected]
References
1.
Dettmer S,
Schaefer-Prokop C,
Shin H.
Die CT-gesteuerte Lungenbiopsie: Indikation,
Technik und Ergebnisse
Radiologie up2date 2013; 13(01): 55-70
2.
Collings C,
Westcott J,
Banson N,
Lange R.
Pneumothorax and Dependent versus Nondependent Patient Position after Needle Biopsy of the Lung
Radiology 1999; 210:1,59-64
3.
Moore EH,
Shepard JO,
McLoud TC,et al.
Positional precautions in needle aspiration lung biopsy.
Radiology 1990;175:733–5
4.
Bourgouin PM,
Shepard JO,
McLoud TC,et al.
Transthoracic needle aspiration biopsy: evaluation of the blood patch technique.
Radiology 1988;166:93–5 [IIb]
5.
Gupta S,...