3:45 PM Abstract No. 151 Factors affecting adverse events in percutaneous lung biopsy for lesions contacting to pleura

Abstract

To retrospectively evaluate factors affecting adverse events in percutaneous lung biopsy for lesions contacting to pleura. From August 2016 to July 2019, 132 consecutive patients with lung tumors measuring 0.6 to 15.0 cm (median, 3.1 cm) and contacting to the pleura underwent percutaneous needle biopsy. There were 87 males and 45 females with their median age of 73-years-old (range, 32–91 years-old). Biopsy was performed under CT fluoroscopic guidance using an 18-gauge end-cut needle. Factors affecting adverse events (AEs) were evaluated by uni- and multivariate analysis including variables such as patient demography, tumor backgrounds, emphysema, puncture number, and needle trajectory (trans-lung or direct puncture). Diagnosis was malignant in 104 patients (78.8%), and benign in 28 patients (21.2%). As a major AEs, pneumothorax requiring chest tube placement developed in 5 patients (3.8%, 5/132), and bacterial or tumor pleural dissemination in 6 patients (2 mycobacterial tuberculosis and 4 carcinoma dissemination) (4.3%, 6/132). Bacterial dissemination developed until 2 weeks after biopsy, and tumor dissemination until 7.9 months (median, 6.2 months). Trans-lung approach was found to be a significant factor for the former AE in both uni- (P = 0.004) and multivariate analysis (P = 0.004). Although there was no significant statistic difference found, the latter AE was only found in patients with direct puncture biopsy {7.0%, 6/86, P = 0.09 as compared with patients with trans-lung biopsy (0%, 0/46)}. Although direct puncture of the target lesion significantly reduces the major pneumothorax rate, it might be associated with a higher risk of tumor or bacterial pleural dissemination in lung lesions contacting to the pleura.