Risk factors influencing chest tube placement among patients with pneumothorax because of CT-guided needle biopsy of the lung

Abstract

The purpose of this study was to evaluate the risk factors for developing a pneumothorax requiring chest tube placement in patients undergoing CT-guided needle biopsy of the lung. In 150 patients, 156 CT-guided needle biopsies of the lung were performed. Patient age, position during biopsy, presence of emphysema, lesion size, depth and location, number of pleural punctures and pleural-puncture angle were analysed as independent risk factors for chest tube placement for pneumothorax. Pneumothorax occurred in 93 of 156 procedures (59.6%), and chest tube placement was required in 12 cases (7.7% of all biopsies, 12.9% of all pneumothoraces). Among patients with a pneumothorax, the proportion of cases biopsied in the supine position was significantly greater in the chest tube placement group (58.3%; 7/12) than in the nonchest tube placement group (28.4%; 23/81) (P=0.026). Patient age, presence of emphysema, lesion size, needle path length, location of pulmonary lesions, number of pleural punctures and the smallest angle between the pleura and the needle showed no significant differences between the two groups. Chest tube insertion was required more frequently in patients biopsied in the supine versus prone position. The prone position is considered preferable to reduce the risk of significant pneumothorax requiring chest tube insertion.