Abstract
BackgroundPneumothorax is one complication of transbronchial biopsy (TBB) using endobronchial ultrasonography with a guide sheath (EBUS-GS-TBB). We sought to clarify the risk factors for pneumothorax after EBUS-GS-TBB under fluoroscopic guidance.MethodsWe retrospectively reviewed data from 916 patients who underwent EBUS-GS-TBB at Fujita Health University Hospital. We evaluated the following risk factors for pneumothorax after EBUS-GS-TBB: patient characteristics (sex, age, and pulmonary comorbidities); lesion data (location, size, existence of ground-glass opacities [GGOs], pleural involvement, computed tomography [CT] bronchus sign, visibility on fluoroscopy, and EBUS findings); final diagnosis; years of bronchoscopist experience; and guide sheath size. Univariate and multivariate logistic regression analyses were performed.ResultsAmong the 916 patients, 30 (3.28%) presented with pneumothorax. With a univariate analysis, factors that independently predisposed to pneumothorax included lesions containing GGOs, lesions in sagittal lung segments on fluoroscopy, lesions that were not visible on fluoroscopy, and infectious lesions. A univariate analysis also showed that lesions in the right upper lobe or left upper division, as well as malignant lesions, were less likely to lead to pneumothorax. Age, underlying pulmonary disease, CT bronchus sign, EBUS findings, bronchoscopist experience, and guide sheath size did not influence the incidence of pneumothorax. A multivariate analysis revealed that only lesions containing GGOs (odds ratio [OR] 6.47; 95% confidence interval [CI] 2.13–19.6, P = 0.001) and lesions in lung segments with a sagittal orientation on fluoroscopy (OR 2.47; 95% CI 1.09–5.58, P = 0.029) were significant risk factors for EBUS-GS-TBB-related pneumothorax.ConclusionsEBUS-GS-TBB of lesions containing GGOs or lesions located in sagittal lung segments on fluoroscopy correlate with a higher pneumothorax risk.
Highlights
Pneumothorax is one complication of transbronchial biopsy (TBB) using endobronchial ultrasonography with a guide sheath (EBUS-GS-TBB)
Statistical analysis To determine the risk factors for pneumothorax after endobronchial ultrasound (EBUS)-GS-TBB, we investigated the clinical factors related to pneumothorax after bronchoscopy, including age (> 75 years), sex, pulmonary comorbidities, lesion location, fluoroscopic view, lesion size, Ground-glass nodule (GGN) (CTR of > 0.5), computed tomography (CT) bronchus sign (CT bronchus sign B or C), pleural contact/indentation, EBUS findings, bronchoscopists’ clinical experience, guide sheath size, and final diagnosis
Thirty patients (3.28%) developed pneumothorax after Endobronchial ultrasonography with a guide sheath (EBUS-GS)-TBB, which was resolved in 22 patients by observation
Summary
Pneumothorax is one complication of transbronchial biopsy (TBB) using endobronchial ultrasonography with a guide sheath (EBUS-GS-TBB). We sought to clarify the risk factors for pneumothorax after EBUS-GS-TBB under fluoroscopic guidance. Gotoh et al BMC Pulm Med (2021) 21:181 biopsy (TBB) using endobronchial ultrasound (EBUS) with a guide sheath (GS), referred to in this paper as EBUS‐GS-TBB, is a recently introduced advanced bronchoscopic technique that has facilitated a higher diagnostic yield for small peripheral lung lesions compared with conventional TBB [2, 3]. Pneumothorax is one of the most common complications of TBB, with an incidence ranging from 1 to 4% [7]. The present study aimed to evaluate the incidence of, and risk factors for, pneumothorax after EBUS-GS-TBB under fluoroscopic guidance
Sign-in/Register to view highlights & summary 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.
