Abstract
Recent data has demonstrated efficacy of a pleural tract sealant system (PTSS; Biosentry) in reduction of rates of pneumothorax (PTX), chest tube placement, and admissions after lung biopsy. The purpose of this study is to compare pneumothorax rate before and after utilization of the PTSS when used in an academic institution in a high risk patient population. A retrospective cohort study was performed of all CT-guided percutaneous lung biopsies at an academic institution from July 2016 to July 2018 to include approximately one year of data before and after PTSS adoption. Exclusion criteria included non-use of PTSS after official adoption, aborted procedures, and incomplete data sets. Independent variables analyzed included age, gender, presence of emphysema, pleural passes, needle in time, lobe laterality, and segment. Primary outcome was presence of a pneumothorax on initial post-biopsy chest radiograph. Data was then analyzed in an A-priori, binary logistic model adjusted for confounders (threshold for inclusion p<0.10). There were 265 patients included in the final analysis (PTSS = 150, No PTSS = 115). Only potential confounding factor meeting inclusion threshold was emphysema (p=.001). There was no difference in the overall between group rates of PTX (13% with PTSS versus 8% without PTSS; p=0.17). Binary logistic analysis discovered a higher incidence of PTX in patients with emphysema with the use of PTSS versus no PTSS. Ultimately emphysema was identified as an independent predictor of PTX in patients in which a PTSS was used (p=.047). PTSS alone or PTSS by needle time failed to be significant independent predictors. Patients with emphysema have higher rates of PTX when using a PTSS system while patients without emphysema have lower rates of post-biopsy PTX. These results suggest that using a PTSS system may be contraindicated in patients with emphysema. Additional prospective studies will be needed.
Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
