The chest X-ray is repeated after three hours to exclude a delayed pneumothorax. Brown KT, Brody LA, Getrajdman GI, et al. rate. Delayed pneumothorax after CT-guided percutaneous fine needle aspiration lung biopsy. However, this is common practice pattern in CTLB since it is not practical to obtain chest radiographs immediately after biopsy CT [20, 34]. Such delayed pneumothorax after lung biopsy is extremely unusual. Incidence and risk factors of delayed pneumothorax after transthoracic needle biopsy of the lung. The incidence of delayed pneumothorax as a complication of subclavian vein catheterisation. We sought to evaluate whether an ICT could replace the routine follow-up chest X-ray (CXR) in detecting procedure … First, the study was based on single institution and population of non-immediate cases were relatively small. 1, 9 Noh et al. After removing the biopsy needle, post-procedure check CT was obtained with the patient in a supine position to detect any complications. In CT-guided transthoracic lung biopsy (CTLB), pneumothorax can occur as a late complication (delayed pneumothorax). 14 cases was identified more than 4 h after biopsy. Methodology, We did not routinely acquire chest radiographs earlier than 4 h after procedure. Percutaneous transthoracic needle biopsy. Discover a faster, simpler path to publishing in a high-quality journal. catheterization (22%), thoracentesis (20%), a transbronchial lung biopsy (10%), pleural biopsy (8%) and positive pressure ventilation (7%) . Patient’s age and gender, lesion size, lesion location (upper lobe vs. middle/lower lobe), lesion type (solid nodule/mass vs. consolidation/GGO), pathologic results (benign vs. malignancy), number of pleural punctures, pleural puncture angle (vertical vs. oblique), length of intrapulmonary biopsy track, needle indwelling time, and the presence or absence of emphysema in the affected lobe were compared among different groups (no pneumothorax, total pneumothorax, immediate pneumothorax, and delayed pneumothorax). Our study showed small lesion size as the only consistent factor related to both immediate and delayed pneumothorax. No, Is the Subject Area "Cancer risk factors" applicable to this article? Personal Information Authors: The factors that were significant in the bivariate analyses were used as variables in multivariate logistic regression to identify independent risk factors for pneumothorax. The disruption of dilated air spaces and the lack of elastic recoil in emphysematous lung may prevent rapid sealing of the air leak, resulting in early manifestations of pneumothorax [32, 33]. Reducing this risk is a goal of those who perform these procedures, particularly a reduction in large pneumothoraces requiring intervention (eg, pleural drainage) and … Further attention and warnings are needed for those with multiple punctures of small lesions involving upper lobes due to the possibility of late development of pneumothorax and higher requirement for chest tube drainage. Rates of chest tube insertion were also compared. absence of an emphysematous change were identified as risk factors for delayed pneumothorax. Pleural injury involving lower lobes with higher aeration and ventilatory movement may lead to early appearance of pneumothorax. By continuing you agree to the, Incidence and Risk Factors of Delayed Pneumothorax After Transthoracic Needle Biopsy of the Lung, picture archiving and communication system. found a significantly higher risk of immediate pneumothorax in patients with emphysema [17]. Thus reduce the rate of pneumothorax requiring drainage catheter placement. View Article PubMed/NCBI Google Scholar 25. Pneumothorax was considered to be “delayed” when it was first detected in follow-up chest radiographs after biopsy. The pneumothorax complicating bronchoscopic transbronchial lung biopsy in our patient was identified at the time of the procedure and was clearly iatrogenic. Pneumothorax developed in 100 of the 458 patients (21.8%), and delayed pneumothorax developed in 15 patients (3.3%). A chest radiograph is obtained after 3 hours to exclude a delayed pneumothorax. Incidence and risk factors of delayed pneumothorax after transthoracic needle biopsy of the lung From CHEST, 11/1/04 by Chang-Min Choi. In 7 cases, tube insertion was conducted after the initial 4 h follow-up chest radiographs. The intrapulmonary needle track was significantly longer in the upper lobes than in the middle/lower lobes (1.81 ± 1.56 cm vs. 1.27 ± 1.25 cm, p < 0.001) in delayed group. Further studies with larger populations are required to corroborate our results. For more information about PLOS Subject Areas, click reported their experience with two cases of pneumothorax occurring 26 and 36 hours after the procedure, in which each target lesion was located in the left and the right upper lobes, respectively [13]. The incidence of delayed pneumothorax was 3.3% of all TTNBs. Adult patients underwent TTNB from June 2001 to June 2002. '-' Wereport devices, and underlying diseases were not correlated with the delayed pneumothorax No, Is the Subject Area "Emphysema" applicable to this article? Delayed pneumothorax was defined as pneumothorax developed after the biopsy needle is removed. Yes One hundred and thirty-nine participants were referred for CT-guided percutaneous lung biopsy, and 81 were … Lesion size was an independent risk factor for both immediate and delayed pneumothorax (OR = 0.813; CI = 0.717–0.922 and OR = 0.610; CI = 0.441–0.844, respectively). Chest. or chest tube insertion rate in delayed pneumothorax was 20% (3 of 15 patients). 3–5 While delayed pneumothorax has been previously reported, our report is unique due to the magnitude of elapsed time between the transbronchial biopsy and the development of the pneumothorax, and the clear evolution … Differences were considered significant at p < 0.05. A timely diagnosis of pneumothorax is clinically important for management of patients. J Thorac Dis 2014;6:S443-7. 184 Management options Where a pneumothorax is detected following a biopsy procedure, the management options include observation, aspiration, or drain insertion. Risk factors for pneumothorax after transthoracic lung biopsy have been examined widely. Pneumothorax developed in 100 of the 458 patients (21.8%), and delayed pneumothorax More than half of immediate pneumothorax was resolved quickly. Copyright: © 2020 Bae et al. No, Is the Subject Area "Medical risk factors" applicable to this article? Manual aspiration in biopsy-side down position demonstrates the safety and efficacy in treating delayed pneumothorax after CT-guided TTNBs. Computed tomography (CT)-guided lung biopsy is a common diagnostic procedure and pneumothorax is the most frequently associated adverse event. Odds ratio; CI, To evaluate the rate of iatrogenic pneumothorax and the need for intervention with extrapleural autologous blood injection (EPABI) along with intraparenchymal autologous blood patch injection (IABPI) or IABPI-only in CT-guided percutaneous lung biopsy. Subsequent weakening of elastic recoil or multiple openings in normal pleura by multiple punctures may facilitate late presentation of pneumothorax. If no major complications were detected, patients were discharged within 24 h after admission. To reduce the risk of pneumothorax necessitating chest tube placement, physicians should adopt the shortest needle path to … In many institutions, biopsy is performed as an outpatient procedure with early discharge [15, 16]. Funding: The authors received no specific funding for this work. Post-biopsy radio- graphs are used to exclude pneumothorax, one of the most common major complications. Click through the PLOS taxonomy to find articles in your field. 14. The demand for lung biopsy is growing due to an increase in detection of lung tumor in screening and the need for molecular and genomic profiling of non-small cell lung cancer [1–3]. Noninvasive Ventilation by Helmet or Face Mask in Immunocompromised Patients, We use cookies to help provide and enhance our service and tailor content and ads. Therefore, lesion location as a risk factor for delayed pneumothorax may differ from that in previous studies in which all cases of pneumothorax were included regardless of the onset time. Procedures were performed under the guidance of 16-slice MDCT scanner (LightSpeed 16, GE Healthcare). No, Is the Subject Area "Pleurae" applicable to this article? Department of Radiology, Gyeongsang National University Changwon Hospital, Changwon, Korea, Roles Risk factors for delayed pneumothorax were lesion size (OR = 0.610; CI = 0.441–0.844), upper lobe location (OR = 5.756; CI = 1.634–20.274), and increased number of pleural punctures (OR = 3.738; CI = 1.860–7.511) (Tables 3 and S1). pmid:15539721 . Citation: Bae K, Ha JY, Jeon KN (2020) Pneumothorax after CT-guided transthoracic lung biopsy: A comparison between immediate and delayed occurrence. The authors received No specific funding for this work there were 372 males and 164 females with symptomatic. In a same patient incidence and the pleural puncture was subsequently made increasing number of pleural punctures [ ]. 184 management options include observation, aspiration, or lateral decubitus positions depending on patients ’ demographics, lesion,. Design, there may have been unidentified bias thickness around the lesion study design, there have! J, et al hypothesized that TBB pneumothorax is clinically important because of considerable. ( LightSpeed 16, GE Healthcare ) CTLB ), and long intrapulmonary biopsy.. Aspiration: economic advantages for the Hospital and patient lung biopsy 16 ] an overall flow of! Most prevalent complication of percutaneous lung biopsy was detected in CT and chest were... 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