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

Moreland, Anna J.; Brody, Lynn A.; Durack, Jeremy C.; Erinjeri, Joseph P.; Getrajdman, George I.; Solomon, Stephen B.; Yarmohammadi, Hooman; Maybody, Majid

doi:10.1007/s00330-015-4200-7

Cited by 34 publications

(27 citation statements)

References 30 publications

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“…This result seems to contradict itself. However, most prior studies did find that performing multiple biopsies was a risk factor of pneumothorax, which is consistent with our findings (37)(38)(39)(40).…”

Section: Discussionsupporting

confidence: 93%

Logistic regression analysis and a risk prediction model of pneumothorax after CT-guided needle biopsy

Zhao¹,

Wang²,

Wang³

et al. 2017

J. Thorac. Dis.

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Background: Pneumothorax is the most common complication of computed tomography (CT)-guided needle biopsy. The purpose of this study was to investigate independent risk factors of pneumothorax, other than emphysema, after CT-guided needle biopsy and to establish a risk prediction model. Methods: A total of 864 cases of CT-guided needle biopsy with an 18-gauge cutting needle were enrolled in this study. The relevant risk factors associated with pneumothorax included age, sex, emphysema, shortaxis size of the lesion, depth of the lesion, body position, and the number of pleural punctures. Several independent risk factors of pneumothorax were found, and a predictive model for pneumothorax was established using univariate and multivariate logistic regression analyses. Results: Pneumothorax occurred in 31.4% (271/864) of cases. Univariate analysis showed that significant risk factors of pneumothorax included age, emphysema, small lesion size, no contact between the lesion and the pleura, prone or lateral body position, and multiple punctures. Independent risk factors of pneumothorax in the multivariate logistic regression analysis included emphysema (P=0.000), no contact between the lesion and the pleura (P=0.000), prone or lateral body position (P=0.002), and the number of pleural punctures (P=0.000). The sensitivity, specificity, and accuracy of the predictive model for pneumothorax were 56.8%, 79.6%, and 72.5%, respectively. Conclusions: Pneumothorax is a common complication of CT-guided lung biopsy. Independent risk factors of pneumothorax include emphysema, no contact between the lesion and the pleura, and prone or lateral body position. The predictive model developed in this study was highly accurate in predicting the incidence of pneumothorax.

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Section: Discussionsupporting

confidence: 93%

Logistic regression analysis and a risk prediction model of pneumothorax after CT-guided needle biopsy

Zhao¹,

Wang²,

Wang³

et al. 2017

J. Thorac. Dis.

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“…The number of applicators used depends on the size of the lesion and the required ablation zone, with MWA providing more flexibility regarding ablation zone size owing to the ability to change ablation time and power settings. The trajectory is planned to traverse the least number of pleural surfaces possible, as this has been shown to decrease the rate of pneumothorax, 29 and to keep the pleural puncture site as far as possible from the ablation zone, as this has been shown to decrease the rate and severity of pneumothorax. 30 For lesions in the periphery of the lung (►Fig.…”

Section: Techniquementioning

confidence: 99%

Microwave Ablation in Primary Lung Malignancies

Moussa

Ziv

Solomon

et al. 2019

Semin intervent Radiol

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Lung cancer is the leading cause of cancer-related mortality worldwide. Eighty-five percent of cases correspond to non-small cell lung cancer (NSCLC) and pivotal nonsurgical options for early-stage disease include percutaneous ablation and stereotactic body radiation therapy (SBRT). Microwave Ablation (MWA) is a locoregional treatment option that has many advantages over radiofrequency ablation and has been able to overcome the limitations of this technique in the treatment of early-stage NSCLC. In this review article, we highlight the current evidence supporting the use of MWA in patients with early-stage NSCLC and discuss the technical considerations of the procedure, including optimal patient selection and planning strategies, as well as the potential complications and reported outcomes. Finally, we mention future trends involving ablation in NSCLC, including its role in combination with SBRT in central tumors, management of post-SBRT local recurrence, and its potential as an adjuvant treatment option for patients with resistance to systemic therapy or in combination with checkpoint inhibitors.

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“…Factors attributable to the increased incidence of pneumothorax and/or the increased requirement of drainage catheters include: tall and thin body types, old age, smoking, underlying lung diseases (e.g. emphysema or chronic obstructive pulmonary disease), deeply located lesions, lesions with small diameters, a biopsy needle not perpendicular to the pleural section, multiple punctures at the pleura, the needle track traverses intrapulmonary fissures or pulmonary bullae, and long operative duration. Pneumothorax generally occurs within an hour after surgery, but some patients may develop delayed pneumothorax (24 hours or later) after surgery .…”

Section: Biopsy Proceduresmentioning

confidence: 99%

Chinese multidisciplinary expert consensus: Guidelines on percutaneous transthoracic needle biopsy

Guo

Shi

et al. 2018

Thoracic Cancer

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Biopsy has been used to diagnose thoracic diseases for more than a century. Percutaneous needle biopsy plays a crucial role in the diagnosis, staging, and treatment planning for tumors in the lungs, thoracic wall, hilum, and mediastinum. With the continuous improvement in imaging techniques, the range of clinical applications for percutaneous needle biopsy is also expanding. It has become important to improve Chinese professionals’ and technicians’ understanding of percutaneous transthoracic needle biopsy (PTNB) in order to standardize operating procedures and to strengthen perioperative management. However, there is currently no Chinese expert consensus that provides systematic standardization and guidance for PTNB in clinical practice. The Committee of Chinese Society of Interventional Oncology (CSIO) of the Chinese Anti‐Cancer Association (CACA) initiated a Chinese multidisciplinary expert consensus on PTNB. The consensus includes image‐guided methods, indications, contraindications, multidisciplinary team recommendations, biopsy procedures, daytime/outpatient biopsy, complications, pathological examination, and management of negative results.

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

Cited by 34 publications

References 30 publications

Logistic regression analysis and a risk prediction model of pneumothorax after CT-guided needle biopsy

Logistic regression analysis and a risk prediction model of pneumothorax after CT-guided needle biopsy

Microwave Ablation in Primary Lung Malignancies

Chinese multidisciplinary expert consensus: Guidelines on percutaneous transthoracic needle biopsy

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