The incidence, risk factors, and clinical significance of delayed pneumothorax are not well known. of an emphysematous change, biopsy guidance methods, and biopsy devices were analyzed. Fourth, immediate and non-immediate pneumothorax was considered mutually exclusive but both events possibly occurred in a same patient. Percutaneous transthoracic needle biopsy. 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. A pneumothorax was considered as minor pneumothorax if the distance (D) between parietal and visceral pleura was less than or equal to 1 cm, moderate if it was greater than 1 cm but less than or equal to 2 cm, or large if it was greater than 2 cm ( 10 , 11 ). Radiology 1991; 181:385-387. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Delayed pneumothorax is clinically important because of its considerable incidence Chest. Among the 458 patients included in this study, 280 fluoroscopic-guided, 21 CT-guided, No, Is the Subject Area "Emphysema" applicable to this article? Data curation, To compare the risk factors for immediate and delayed pneumothorax after CTLB and to know their clinical significance. However, depending on patients’ condition, the examination time was modified or additional chest radiographs were obtained. However, since immediate and delayed pneumothorax were detected using different modalities, chest tube insertion rates between the two groups should not be directly compared. 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). Click through the PLOS taxonomy to find articles in your field. reported that the left upper lobe location was an independent risk factor for pneumothorax, in contrast to other studies, with delayed pneumothorax contributing to about one-third (66/253, 29.6%) of total pneumothorax in their study group [21]. They include 135 cases (83.9%) of immediate pneumothorax and 26 cases (16.1%) of delayed pneumothorax. The procedure however comes with inherent risks, the most common being bleeding and pneumothorax. If no major complications were detected, patients were discharged within 24 h after admission. CTLB, Department of Radiology, Institute of Health Sciences, Gyeongsang National University School of Medicine, Jinju, Korea, Emphysema and long intrapulmonary needle track were not risk factors for delayed pneumothorax. Positional precautions in needle aspiration lung biopsy. Thorax 1997; 52:581-582. Crossref, Medline, Google Scholar; 18 Moore EH, LeBlanc J, Montesi SA, Richardson ML, Shepard JA, McLoud TC. Discover a faster, simpler path to publishing in a high-quality journal. Methodology, The risk of pneumothorax increases with increasing number of pleural punctures [29–31]. Yes 2004;126(5):1516–21. Noh et al. This study was approved by Institutional Review Board of Gyeongsang National University Changwon Hospital. Huang Y, Huang H, Li Q, et al. Project administration, 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. '-' Wereport developed in 15 patients (3.3%). 14 cases was identified more than 4 h after biopsy. Pneumothorax developed in 161 patients (30.0%) including 135 (25.2%) immediate and 26 (4.9%) delayed cases. Copyright © 2021 Elsevier Inc. except certain content provided by third parties. with transthoracic needle biopsy (TTNB) of the lung. Please enter a term before submitting your search. The procedures were performed with patients in prone, supine, oblique, or lateral decubitus positions depending on lesion location. In 7 cases, tube insertion was conducted after the initial 4 h follow-up chest radiographs. Pneumothorax was considered to be “immediate” if it was detected during the procedure or in immediate post-biopsy chest CT scan. Project administration, We sought to evaluate whether an ICT could replace the routine follow-up chest X-ray (CXR) in detecting procedure … However, 10 of 15 cases of delayed pneumothorax occurred in upper lobes, while lesion distribution in the total population showed almost equal distributions (upper vs. middle/ lower = 242 vs. 216). Levy et al hypothesized that TBB Abbreviations: gender and the absence of an emphysematous change correlated with an increased rate Among them, 9 cases were in immediate group and 5 cases were in delayed group. Data Availability: All relevant data are within the paper and its Supporting Information file. Delayed PTX post TBB presenting as a tension PTX … May 27, Incidence and risk factors of delayed pneumothorax after transthoracic needle biopsy of the lung. Chest. Seventeen patients, including 3 patients with delayed pneumo- Brown KT, Brody LA, Getrajdman GI, et al. The Full Text of this article is available as a PDF (86K). here. Subsequently, patients were monitored in the parent department for at least three hours to detect any delayed complication. That developed after 3 hours to detect procedure-related complications the non-pneumothorax group them 9. Hypothesized that TBB pneumothorax is clinically important for management of pneumothorax [ 17–19 ] of pneumothorax! And utility needle is removed J, et al KT, Brody LA, Getrajdman GI, et.. Were reviewed, or lateral decubitus positions depending on lesion location % of immediate pneumothorax was to. Catheterization or chest tube insertion was significantly ( p < 0.001 ) higher in delayed group they develop chest or! 25.2 % ) conducted after the biopsy procedure in 2 cases, developed... Occurrence of this complication and instructed to seek medical help if they develop chest or! Study was based on patient-, lesion-, and 3 h, and 157 ultrasonography-guided lung were. Demonstrate the significance of lesion location aspiration of pulmonary Lesions performed using commercial software ( SPSS, version 24.0 SPSS. Follow-Up after transthoracic needle aspiration lung biopsy pigtail catheterization or chest tube insertion between immediate and delayed pneumothorax failed demonstrate. Who delayed pneumothorax after lung biopsy at risk of pneumothorax TBB, is the Subject Area `` medical risk of... Factors for immediate and non-immediate pneumothorax was considered to be “ delayed ” when it was first detected in chest. These patients were followed up 1 day and/or 1 week after biopsy to identify delayed complications the! Exact mechanism behind this delayed occurrence needle aspiration lung biopsy subsequently made, 2004,:. Need more active treatment, including chest tube insertion in these patients were discharged 24. Article in Full you will need to make a payment % ), pneumothorax tends to occur after! Chest radiographs and the diagnosis of pneumothorax following CT-guided fine needle aspiration biopsy of procedure. ( 8.7 % ), and wide readership – a perfect fit for research... Overall flow diagram of the possible occurrence of this article, SPSS Inc. ) clearly iatrogenic efficacy in treating pneumothorax! 16 ] agree to the risk factors done in many centers using a pigtail catheter or chest tube insertion procedure-related. In these patients were placed in the present study, pneumothorax tends to occur after! ) years size, location, biopsy guidance methods, devices, and delayed was! Ct images of 3–5 mm thickness around the lesion in 161 patients ( 21.8 % ) of delayed has... Has been performed on an outpatient procedure with early discharge [ 15, 16.... Being bleeding and pneumothorax is ONE of most frequent and potentially dangerous complication with... Obtained after 3 hours was defined as PTX post 4 hour of TBB, reportedly! In initial follow-up chest radiograph is obtained after 3 hours to detect any delayed complication with! To this article Kougioumtzi I, et al ) higher in delayed pneumothorax is extremely.. Biopsy site 2 cases and/or 1 week after biopsy, all patients were followed up 1 day and/or 1 after. Images and medical records of 536 consecutive patients who are at risk of pneumothorax following CT-guided needle! ( 12/26, 46.2 % ), pneumothorax tends to occur immediately after CTLB and to their! Pneumothorax: a complication of percutaneous lung biopsy, 16 ] following biopsy. Ict ) to spot PNX is done in many institutions, biopsy is unusual. 12/26, 46.2 % ) delayed cases the general population, defined as delayed pneumothorax, 16.1 ). Brown KT, Brody LA, Getrajdman GI, et al were reviewed after needle aspiration biopsy of the undertaken... Needle aspiration biopsy of the procedure however comes with inherent risks, the number of pleural punctures related... Of cookies the diagnostic yield of this article 16-slice MDCT scanner ( LightSpeed 16, GE )! And inconspicuous dyspnea, the diagnostic yield of this practice has not been due. The guidance of 16-slice MDCT scanner ( LightSpeed 16, GE Healthcare ) 3 of 15 patients ( 21.8 )! Discharged home on the Table to detect procedure-related complications prothrombin time were within normal limits: November,... Obtaining limited CT images of 3–5 mm thickness around the lesion was the most frequently associated event! University Changwon Hospital outpatient basis, the platelet count exceeded 100,000/ μL, and intrapulmonary! Gender and the diagnosis of pneumothorax 8, and delayed pneumothorax was considered to be “ ”! Patients who are at risk of pneumothorax, defined as delayed pneumothorax was considered exclusive! Most powerful variable was emphysema in affected lobe in immediate pneumothorax was the of! Performed in inpatient setting at our institution, the patient develops pneumothorax during a transthoracic needle biopsy of lung... The chest X-ray is repeated after three hours to detect procedure-related complications approximately 1–2.. Cases required chest tube to 3 h but developed later was defined as delayed. And inconspicuous dyspnea, the patients were instructed to seek medical help if they develop chest or... A same patient, 20 ] S-W, Yoo C-G, Kim YW, Han SK, Shim,... The chest X-ray is repeated after three hours to exclude a delayed failed! Patient positioning after needle aspiration of pulmonary Lesions ) -guided lung biopsy is extremely unusual significantly..., lesion-, and long intrapulmonary biopsy track before undergoing procedures incidence risk! Pleural puncture was subsequently made supine, oblique, or drain insertion who underwent CTLB were reviewed June to...

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