Age as a risk factor in the occurrence of pneumothorax after transthoracic fine needle biopsy: Our experience

Vatrella, Alessandro; Galderisi, Antonio; Nicoletta, Carmine; Maglio, Angelantonio; Cortese, Antonio; Crescenzo, Rosa Maria Di; Ieni, Antonio; Crisci, Alfonso; Crescenzo, Vincenzo Giuseppe Di

doi:10.1016/j.ijsu.2014.08.387

Cited by 14 publications

(10 citation statements)

References 33 publications

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“…Though CPLB is generally well-tolerated, complications of CPLB include pneumothorax, pulmonary hemorrhage (hemoptysis and hemothorax), air embolism, tumor seeding, and infection [19; 30]. Pneumothorax and pulmonary hemorrhage occur most commonly, while other complications are rare [19].…”

Section: Discussionmentioning

confidence: 99%

Pneumothorax with prolonged chest tube requirement after CT-guided percutaneous lung biopsy: incidence and risk factors

et al. 2016

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PURPOSE To evaluate the incidence and risk factors of pneumothoraces requiring prolonged maintenance of a chest tube following CT-guided percutaneous lung biopsy in a retrospective, single-center case series. MATERIALS AND METHODS All patients undergoing CT-guided percutaneous lung biopsies between 06/2012 and 05/2014 who required chest tube insertion for symptomatic or enlarging pneumothoraces were identified. Based on chest tube dwell time, patients were divided into two groups: short-term (0–2 days) or prolonged (3 or more days). The following risk factors were stratified between groups: patient demographics, target lesion characteristics, and procedural/periprocedural technique and outcomes. RESULTS 2337 patients underwent lung biopsy, 543 developed pneumothorax (23.2%), 187 required chest tube placement (8.0%), and 55 required a chest tube for three days or more (2.9% of all biopsies, 29.9% of all chest tubes). The median chest tube dwell time for short-term and prolonged groups was 1.0 days and 4.7 days, respectively. Transfissural needle path predicted prolonged chest tube requirement (OR: 2.5; p=0.023). Other factors were not significantly different between groups. CONCLUSION 2.9% of patients undergoing CT guided lung biopsy required a chest tube for 3 or more days. Transfissural needle path during biopsy was a risk factor for prolonged chest tube requirement.

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Section: Discussionmentioning

confidence: 99%

Pneumothorax with prolonged chest tube requirement after CT-guided percutaneous lung biopsy: incidence and risk factors

et al. 2016

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“…In single-center studies, older patient age was found to be an independent risk factor for pneumothorax [14,30]. However, some studies showed that the risk peaked in patients in their 60s or 70s [17,31]. These results could be explained by the possibility that relatively few patients who were very elderly or in an inadequate condition to undergo the procedure were included.…”

Section: Plos Onementioning

confidence: 99%

Patterns of percutaneous transthoracic needle biopsy (PTNB) of the lung and risk of PTNB-related severe pneumothorax: A nationwide population-based study

et al. 2020

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Background As percutaneous transthoracic needle biopsy (PTNB) of the lung is a well-established diagnostic method for the evaluating pulmonary lesions, evidence of safety based on representative data is limited. This study investigated the practice patterns of PTNB of the lung and assessed the incidence and risk factors of PTNB-related severe pneumothorax in Korea. Methods We used a national-level health insurance database between January 1, 2007 and December 31, 2015. Patients who underwent PTNB of the lung were identified using procedure codes for organ biopsy, fluoroscopy, computed tomography, chest radiography, and lungrelated diagnosis codes. The annual age-/sex-standardized rate of PTNB and the incidence of PTNB-related severe pneumothorax were calculated. We defined severe pneumothorax as the pneumothorax requiring intervention. The odds ratios of risk factors were assessed by a generalized estimating equation model with exchangeable working correlation matrix to address clustering effect within institution.

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“…Many factors were considered to increase the risk of pneumothorax, such as age over 60 years old, diameter and depth of tumor, puncture of a fissure, chronic obstructive pulmonary disease and emphysema. [20–22] In fact, it is difficult to compare complication results of CPLB between published studies due to inconsistent or even contradictory results owing to various biopsy techniques, defined risk factors, statistical methods and baseline characteristics of lung imaging, and puncture experience, suggesting that the incidence of CPLB-induced complications is multivariate and complex. [23–25]…”

Section: Discussionmentioning

confidence: 99%

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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Age as a risk factor in the occurrence of pneumothorax after transthoracic fine needle biopsy: Our experience

Cited by 14 publications

References 33 publications

Pneumothorax with prolonged chest tube requirement after CT-guided percutaneous lung biopsy: incidence and risk factors

Pneumothorax with prolonged chest tube requirement after CT-guided percutaneous lung biopsy: incidence and risk factors

Patterns of percutaneous transthoracic needle biopsy (PTNB) of the lung and risk of PTNB-related severe pneumothorax: A nationwide population-based study

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

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