Manual aspiration of a pneumothorax after CT-guided lung biopsy: outcomes and risk factors.

التفاصيل البيبلوغرافية
العنوان:	Manual aspiration of a pneumothorax after CT-guided lung biopsy: outcomes and risk factors.
المؤلفون:	Chan MV; Department of Medical Imaging, University Health Network, University of Toronto, Toronto, Canada.; Department of Radiology, Concord Repatriation General Hospital, NSW, Concord, NSW, Australia.; Concord Hospital Clinical School, University of Sydney, NSW, Concord, Australia., Afraz Z; Department of Medical Imaging, University Health Network, University of Toronto, Toronto, Canada., Huo YR; Department of Radiology, Concord Repatriation General Hospital, NSW, Concord, NSW, Australia.; Concord Hospital Clinical School, University of Sydney, NSW, Concord, Australia., Kandel S; Department of Medical Imaging, University Health Network, University of Toronto, Toronto, Canada., Rogalla P; Department of Medical Imaging, University Health Network, University of Toronto, Toronto, Canada.
المصدر:	The British journal of radiology [Br J Radiol] 2023 Aug; Vol. 96 (1148), pp. 20220366. Date of Electronic Publication: 2023 Jun 28.
نوع المنشور:	Journal Article
اللغة:	English
بيانات الدورية:	Publisher: Oxford University Press Country of Publication: England NLM ID: 0373125 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1748-880X (Electronic) Linking ISSN: 00071285 NLM ISO Abbreviation: Br J Radiol Subsets: MEDLINE
أسماء مطبوعة:	Publication: January 2024- : [Oxford] : Oxford University Press Original Publication: London, British Institute of Radiology.
مواضيع طبية MeSH:	Pneumothorax*/etiology, Humans ; Retrospective Studies ; Lung/diagnostic imaging ; Lung/pathology ; Biopsy, Needle/adverse effects ; Image-Guided Biopsy/adverse effects ; Tomography, X-Ray Computed/adverse effects ; Risk Factors ; Radiography, Interventional/adverse effects
مستخلص:	Objective: Quantify the outcomes following pneumothorax aspiration and influence upon chest drain insertion. Methods: This was a retrospective cohort study of patients who underwent aspiration for the treatment of a pneumothorax following a CT percutaneous transthoracic lung biopsy (CT-PTLB) from January 1, 2010 to October 1, 2020 at a tertiary center. Patient, lesion and procedural factors associated with chest drain insertion were assessed with univariate and multivariate analyses. Results: A total of 102 patients underwent aspiration for a pneumothorax following CT-PTLB. Overall, 81 patients (79.4%) had a successful pneumothorax aspiration and were discharged home on the same day. In 21 patients (20.6%), the pneumothorax continued to increase post-aspiration and required chest drain insertion with hospital admission. Significant risk factors requiring chest drain insertion included upper/middle lobe biopsy location [odds ratio (OR) 6.46; 95% CI 1.77-23.65, p = 0.003], supine biopsy position (OR 7.06; 95% CI 2.24-22.21, p < 0.001), emphysema (OR 3.13; 95% CI 1.10-8.87, p = 0.028), greater needle depth ≥2 cm (OR 4.00; 95% CI 1.44-11.07, p = 0.005) and a larger pneumothorax (axial depth ≥3 cm) (OR 16.00; 95% CI 4.76-53.83, p < 0.001). On multivariate analysis, larger pneumothorax size and supine position during biopsy remained significant for chest drain insertion. Aspiration of a larger pneumothorax (radial depths ≥3 cm and ≥4 cm) had a 50% rate of success. Aspiration of a smaller pneumothorax (radial depth 2-3 cm and <2 cm) had an 82.6% and 100% rate of success, respectively. Conclusion: Aspiration of pneumothorax after CT-PTLB can help reduce chest drain insertion in approximately 50% of patients with larger pneumothoraces and even more so with smaller pneumothoraces (>80%). Advances in Knowledge: Aspiration of pneumothoraces up to 3 cm was often associated with avoiding chest drain insertion and allowing for earlier discharge. Competing Interests: Conflict of InterestPA, SK and ZA – Institutional Master Research agreement, Canon Medical Systems. MVC and YRH – no conflicts.
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تواريخ الأحداث:	Date Created: 20230702 Date Completed: 20230724 Latest Revision: 20230803
رمز التحديث:	20231215
مُعرف محوري في PubMed:	PMC10392636
DOI:	10.1259/bjr.20220366
PMID:	37393532
قاعدة البيانات:	MEDLINE

الوصف
تدمد:	1748-880X
DOI:	10.1259/bjr.20220366