Pneumothorax with prolonged chest tube requirement after CT-guided percutaneous lung biopsy: incidence and risk factors.

Abstract

To evaluate the incidence and risk factors of pneumothoraces requiring prolonged maintenance of a chest tube following CT-guided percutaneous lung biopsy in a retrospective, single-centre case series. All patients undergoing CT-guided percutaneous lung biopsies between June 2012 and May 2014 who required chest tube insertion for symptomatic or enlarging pneumothoraces were identified. Based on chest tube dwell time, patients were divided into two groups: short term (0-2days) or prolonged (3 or more days). The following risk factors were stratified between groups: patient demographics, target lesion characteristics, and procedural/periprocedural technique and outcomes. A total of 2337 patients underwent lung biopsy; 543 developed pneumothorax (23.2%), 187 required chest tube placement (8.0%), and 55 required a chest tube for 3days or more (2.9% of all biopsies, 29.9% of all chest tubes). The median chest tube dwell time for short-term and prolonged groups was 1.0days and 4.7days, respectively. The transfissural needle path predicted prolonged chest tube requirement (OR: 2.5; p = 0.023). Other factors were not significantly different between groups. Of patients undergoing CT-guided lung biopsy, 2.9% required a chest tube for 3 or more days. Transfissural needle path during biopsy was a risk factor for prolonged chest tube requirement. • CT-guided percutaneous lung biopsy (CPLB) is an important method for diagnosing lung lesions • A total of 2.9% of patients require a chest tube for ≥3days following CPLB • Transfissural needle path is a risk factor for prolonged chest tube time.