Rapid needle-out patient-rollover approach after cone beam CT-guided lung biopsy: effect on pneumothorax rate in 1,191 consecutive patients View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2015-07

AUTHORS

Jung Im Kim, Chang Min Park, Sang Min Lee, Jin Mo Goo

ABSTRACT

OBJECTIVES: To investigate the effect of rapid needle-out patient-rollover approach on the incidence of pneumothorax and drainage catheter placement due to pneumothorax in C-arm Cone-beam CT (CBCT)-guided percutaneous transthoracic needle biopsy (PTNB) of lung lesions. METHODS: From May 2011 to December 2012, 1227 PTNBs were performed in 1191 patients with a 17-gauge coaxial needle. 617 biopsies were performed without (conventional-group) and 610 with rapid-rollover approach (rapid-rollover-group). Overall pneumothorax rates and incidences of pneumothorax requiring drainage catheter placement were compared between two groups. RESULTS: There were no significant differences in overall pneumothorax rates between conventional and rapid-rollover groups (19.8% vs. 23.1%, p = 0.164). However, pneumothorax rate requiring drainage catheter placement was significantly lower in rapid-rollover-group (1.6%) than conventional-group (4.2%) (p = 0.010). Multivariate analysis revealed male, age > 60, bulla crossed, fissure crossed, pleura to target distance > 1.3 cm, emphysema along needle tract, and pleural punctures ≥ 2 were significant risk factors of pneumothorax (p < 0.05). Regarding pneumothorax requiring drainage catheter placement, fissure crossed, bulla crossed, and emphysema along needle tract were significant risk factors (p < 0.05), whereas rapid-rollover approach was an independent protective factor (p = 0.002). CONCLUSIONS: The rapid needle-out patient-rollover approach significantly reduced the rate of pneumothorax requiring drainage catheter placement after CBCT-guided PTNB. KEY POINTS: • The rapid-rollover approach had little beneficial effect on overall pneumothorax rate. • The rapid-rollover approach significantly reduced drainage catheter placement due to pneumothorax. • The strongest risk factor was pleural punctures ≥ 2 per procedure. • Emphysema along the needle tract was a stronger risk factor than fissure-crossed. More... »

PAGES

1845-1853

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00330-015-3601-y

DOI

http://dx.doi.org/10.1007/s00330-015-3601-y

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1017834318

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/25636421


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54 schema:description OBJECTIVES: To investigate the effect of rapid needle-out patient-rollover approach on the incidence of pneumothorax and drainage catheter placement due to pneumothorax in C-arm Cone-beam CT (CBCT)-guided percutaneous transthoracic needle biopsy (PTNB) of lung lesions. METHODS: From May 2011 to December 2012, 1227 PTNBs were performed in 1191 patients with a 17-gauge coaxial needle. 617 biopsies were performed without (conventional-group) and 610 with rapid-rollover approach (rapid-rollover-group). Overall pneumothorax rates and incidences of pneumothorax requiring drainage catheter placement were compared between two groups. RESULTS: There were no significant differences in overall pneumothorax rates between conventional and rapid-rollover groups (19.8% vs. 23.1%, p = 0.164). However, pneumothorax rate requiring drainage catheter placement was significantly lower in rapid-rollover-group (1.6%) than conventional-group (4.2%) (p = 0.010). Multivariate analysis revealed male, age > 60, bulla crossed, fissure crossed, pleura to target distance > 1.3 cm, emphysema along needle tract, and pleural punctures ≥ 2 were significant risk factors of pneumothorax (p < 0.05). Regarding pneumothorax requiring drainage catheter placement, fissure crossed, bulla crossed, and emphysema along needle tract were significant risk factors (p < 0.05), whereas rapid-rollover approach was an independent protective factor (p = 0.002). CONCLUSIONS: The rapid needle-out patient-rollover approach significantly reduced the rate of pneumothorax requiring drainage catheter placement after CBCT-guided PTNB. KEY POINTS: • The rapid-rollover approach had little beneficial effect on overall pneumothorax rate. • The rapid-rollover approach significantly reduced drainage catheter placement due to pneumothorax. • The strongest risk factor was pleural punctures ≥ 2 per procedure. • Emphysema along the needle tract was a stronger risk factor than fissure-crossed.
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