Efficiency of Hydrogel Plugging System in Non-Pleural Lung Masses

Abstract

Objective: The aim of this study is to evaluate the complications of non-pleural-based lung biopsies performed under Computed Tomography (CT) guidance, and the ability of the hydrogel plugging system to prevent them. Material and method: Biopsy were performed in 49 cases with non-pleural-based lung mass with a coaxial system, accompanied by CT. Hydrogel plug was immediately inserted into the tissue without removing the coaxial needle. At the end of the procedure and 2 hours later, a 5 cm area in the biopsy area was controlled by CT, and 24 hours later by chest X-ray. Pneumothoraxes detected even in a single control were accepted as positive results. The data obtained were evaluated regarding the literature based on the parameters like mass size, pleural distance, presence of emphysema, age, smoking history, passing fissure. Results: Pneumothorax was the most encountered complication observed in 13 cases (26.5%) in the study. Thorax tube was placed in 1 of these cases (2.04 %). The highest rate of pneumothorax development was detected in lesions over 4 cm (33.3%) distance. In cases where fissure was passed, pneumothorax occurred in 5 (71.4%) patients. When patients with and without pneumothorax were compared in terms of age, a statistically significant difference was found (p = 0.048). Discussion: The results show that hydrogel plug application is a successful and safe method. When pneumothorax cases were analyzed, the development of massive pneumothorax requiring tube drainage in only one case and the acceptable percentage of pneumothorax can be considered as the success of the method.

Keywords

• Pneumothorax
• Lung
• Mass
• Biopsy
• Hydrogel

Plevral Tabanlı Olmayan Akciğer Kitlelerinde Hidrojel Tıkaç Sistemi Etkinliği

Öz

Öz Amaç: Bu çalışma Bilgisayarlı Tomografi (BT) kılavuzluğunda yapılan plevral tabanlı olmayan akciğer biyopsilerinde gerçekleşen komplikasyonları ve hidrojel tıkama sisteminin bunları önleme yeteneğini değerlendirmek için yapılmıştır. Gereç ve yöntem: Plevral tabanlı olmayan akciğer kitle biyopsisi planlanan 46 vakaya BT eşliğinde koaksiyel sistemle biyopsi yapıldı. Takiben koaksiyel iğne çıkarılmadan hemen hidrojel tıkaç dokuya yerleştirildi. İşlem bitiminde ve 2 saat sonrasında biyopsi bölgesinde 5 cm’lik bir sahaya BT ile, 24 saat sonra akciğer grafisiyle kontrol edildi. Tek bir kontrolde bile saptanan pnömotorakslar pozitif sonuç olarak kabul edildi. Elde edilen veriler kitle boyutu, plevral mesafe, amfizem varlığı, yaş, sigara öyküsü, fissür geçme parametreleriyle literatür verileriyle karşılaştırılarak değerlendirildi. Bulgular: Çalışmada en çok saptanan komplikasyon 13 olgu (%26,5) ile pnömotoraks oldu. Bu olgulardan 1’ine (%2,04) toraks tüpü yerleştirildi. En yüksek pnömotoraks gelişme oranı 4 cm üstü (%33,3) lezyonlarda saptandı. Fissür geçilen olgularda 5 vakada (%71,4) pnömotoraks gerçekleşti. Pnömotoraks gelişen ve gelişmeyen hastalar yaşdeğişkeni açısından karşılaştırıldığında istatistiksel olarak anlamlı farklılık bulundu(p=0.048). Sonuç: Sonuçlara göre hidrojel tıkaç uygulamasının başarılı ve güvenli bir yöntem olduğunu göstermektedir. Pnömotoraks olguları analiz edildiğinde sadece bir olguda tüp drenajı gerektiren düzeyde masif pnömotoraks gelişmesi ve pnömotoraks yüzdesinin kabul edilebilir düzeyde olması yöntemin başarısı olarak kabul edilebilir.

Anahtar Kelimeler

• Pnömotoraks
• Akciğer
• Kitle
• Biyopsi
• Hidrojel

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