Evaluation of major complications associated with percutaneous CT-guided biopsy of lung nodules below 3 cm

Abstract

Background/aim: The aim of this study was to evaluate retrospectively the incidence and risk factors for the serious complications ofpneumothorax and/or parenchymal haemorrhage occurring after computed tomography (CT) guided transthoracic biopsy.Materials and methods: The relation between the incidence of pneumothorax and parenchymal haemorrhage due to biopsy, age,sex, lesion localization, lesion size, duration of the procedure, depth of lesion, number of pleural insertions of the biopsy needle andpathology results were statistically evaluated.Results: Between 2016 and 2017, 309 cases with lesions below 3 cm in diameter of a total of 768 (40.2%) CT-guided chest biopsypatients were selected for retrospective review. The rate of pneumothorax and parenchymal haemorrhage was 18.1% (59/309) and 51%(158/309), respectively post biopsy. The number of needle pleural insertions was correlated with the development of pneumothorax(P = 0.002). At regression analysis, for parenchymal haemorrhage, lesion depth (P < 0.001) and total procedure time (p=0.036) weredetermined as the most important independent risk factors.Conclusion: Pneumothorax and parenchymal haemorrhage are common complications after CT-guided percutaneous biopsy. Theminimum number of needle-pleural insertions, the optimal access route to the lesion and as quick as possible biopsy procedure shouldbe selected to reduce the risk of pneumothorax and parenchymal haemorrhage.