Abstract
The purpose of this paper is to evaluate whether meteorological variables influence rates of pneumothorax and chest tube placement after percutaneous transthoracic needle biopsy (PTNB) of pulmonary nodules. A retrospective review of 338 consecutive PTNBs of pulmonary nodules at a single institution was performed. All procedures implemented a coaxial approach, using a 19-gauge outer guide needle for access and a 20-gauge core biopsy gun with or without a small-gauge aspiration needle for tissue sampling. Correlation between age, sex, smoking history, lesion size, meteorological variables, and frequency of complications were evaluated. Fisher exact, trend and t tests were used to evaluate the relationship between each factor and rates of pneumothorax and chest tube placement. A p value of less than 0.05 was considered to indicate a statistically significant difference. Pneumothorax occurred in 115 of 338 patients (34%). Chest tube placement was required in 30 patients (8.9%). No significant relationship was found between pneumothorax rate and age (p = 0.172), sex (p = 0.909), smoking history (p = 0.819), or lesion location (p = 0.765). The presence or absence of special weather conditions did not correlate with the rate of pneumothorax (p = 0.241) or chest tube placement (p = 0.213). The mean atmospheric temperature (p = 0.619) and degree of humidity (p = 0.858) also did not correlate with differences in the rate of pneumothorax. Finally, mean atmospheric pressure on the day of the procedure demonstrated no correlation with the rate of pneumothorax (p = 0.277) or chest tube placement (p = 0.767). In conclusion, no correlation is demonstrated between the occurrence of pneumothorax after PTNB of pulmonary nodules and the studied meteorological variables.
Highlights
Computed tomography (CT)-guided percutaneous transthoracic needle biopsy (PTNB) is a well-established, safe, effective, and commonly used procedure in the diagnosis of pulmonary lesions [1,2]
The aim of this study was to evaluate the possible associations of meteorological variables with pneumothorax development and need for chest tube placement following CT-guided PTNB of pulmonary nodules
Chest tube placement was required in 30 patients; 26% of patients with pneumothorax and 8.9% of all patients undergoing biopsy
Summary
Computed tomography (CT)-guided percutaneous transthoracic needle biopsy (PTNB) is a well-established, safe, effective, and commonly used procedure in the diagnosis of pulmonary lesions [1,2]. Pneumothorax remains the most frequent complication of PTNB, with a reported incidence ranging from 12 to 45% [3,4,5,6,7,8]. Patient management after pneumothorax typically requires prolonged observation, multiple imaging studies, and sometimes needle evacuation of air, while tube placement may necessitate admission for overnight observation. These complications significantly impact the ease, cost, and patient experience of PTNB of lung nodules, which is typically performed on an outpatient basis. The identification of risk factors may help predict, and potentially avert, the development of these complications
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