Pneumothorax and pulmonary hemorrhage frequency and risk factors of computed tomography-guided transthoracic pulmonary biopsy complications

Abstract

Introduction: We aimed to analyze the frequency and risk factors of pneumothorax and pulmonary hemorrhage caused by Computed Tomography (CT) guided needle biopsy. Methods: Demographical features, pneumothorax and pulmonary hemorrhage frequencies/risk factors, characteristics of lesions of patients who underwent a CT-guided lung biopsy in our institution between January 2013 and August 2013 were reviewed retrospectively. The lesions were classified to the groups as nodular lesions≤3 cm in diameter, nodular lesions>3 cm and consolidated lesions. Pneumothorax and pulmonary hemorrhage frequencies among groups were compared using a chi-square test. A p<0.05 was accepted as statistically significant. Results: A total number of 122 patients with a mean age of 61±13 (19-88) years were included. 28 (23%) patients were female and 94 (77%) were male. 30 (24%) lesions were nodular lesions≤3 cm in diameter, 57 (47%) were nodular lesions>3 cm, and 35 (29%) were consolidated lesions. Pneumothorax developed in 15 (12%) patients while a chest tube insertion was required in 4 (3%) of them. Pulmonary hemorrhage occurred in 14 (11%) patients. Hemoptysis and hemothorax were not observed in this study. Pleura-based lesions was significantly less associated with pneumothorax when compared with ones far from pleura (P<0.001). Usage of 17-gauge needle was significantly more associated with pneumothorax than 19-gauge (p:0.048). Pulmonary hemorrhage was significantly less observed during the biopsy of lesions>3 cm than<3 cm (P<0.001). Conclusion: Nodular lesions≤3 cm, location far from pleura and usage of 17-gauge needle tend to be associated with more frequent lung biopsy complications.