BİLGİSAYARLI TOMOGRAFİ EŞLİĞİNDE YAPILAN TRANSTORASİK İNCE İĞNE ASPİRASYON BİYOPSİLERİNDE PNÖMOTORAKS GELİŞİMİNİ ETKİLEYEN RİSK FAKTÖRLERİ

Abstract

Amaç: Çalışmamızda bilgisayarlı tomografi (BT) eşliğinde yapılan transtorasik ince iğne aspirasyon biyopsilerinde (TİİAB) çeşitli faktörlerin başta pnömotoraks olmak üzere gelişebilecek komplikasyonlar ile ilişkisini değerlendirmeyi amaçladık. Gereç ve Yöntemler: Bu retrospektif çalışma Ocak 2015- Temmuz 2015 tarihleri arasında tekrarlanan işlemler ile birlikte 120 adet TİİAB yapılmış olan 114 hastanın görüntüleri incelenerek gerçekleştirildi. Lezyonla ilgili bilgiler, biyopsi traktında geçilen mesafeler ve patolojiler, hasta pozisyonu, iğne ile ilgili bilgiler ve gelişen komplikasyonlar değerlendirilip bulgular kaydedildi. Bulgular: İşlem sırasında ve sonrasında 37 hastada (%30,8) parankimal hemoraji ve 22 hastada (%18,3) pnömotoraks komplikasyonu gelişmiş olup bunlardan 5 tanesine (%4,2) plevral drenaj tedavisi uygulandı. Pnömotoraks gelişimi ile geçilen parankim mesafesi (p=0,008), geçilen toplam mesafe (p=0,001), biyopsi traktında fissür veya amfizemli doku varlığı (p=0,001), hasta yatış pozisyonu (p=0,001) arasında anlamlı korelasyon saptanmıştır. Sonuç: TİİAB işlemi yapılırken pnömotoraks oranını azaltmak için hastaya lateral dekübit pozisyon vermekten kaçınılmalı, biyopsi giriş yeri planlanırken traktta amfizemli doku veya fissür olmamasına dikkat edilmeli ve kitleye ulaşılacak mümkün olan en kısa mesafe seçilmelidir.

Keywords

• Akciğer neoplazileri
• görüntüleme eşliğinde biyopsi
• pnömotoraks

Risk Factors Affecting the Development of Pneumothorax in Transthoracic Fine Needle Aspiration Biopsys Performed with Computed Tomography

Abstract

Objective: In our study, we aimed to evaluate the relationship of various factors with complications that may develop, especially pneumothorax, in transthoracic fine needle aspiration biopsies (FNAB) performed under computed tomography (CT) guidance. Material and Methods: This retrospective study reviewed lung biopsy results of 114 patients who underwent 120 FNABs with repeated procedures performed between January 2015 and July 2015. Information about the lesion, distances and pathologies passed in the biopsy tract, patient position, information about the needle entry and developing complications were evaluated and the findings were recorded. Results: During and after the procedure 37 patients (30.8%) developed parenchymal hemorrhage and 22 patients (18.3%) developed pneumothorax complications. 5 of patients with pneumothorax (4.2%) were treated with pleural drainage. There was a significant correlation between development of pneumothorax and traversed parenchymal distance (p=0.008), traversed total distance (p=0.001) , presence of fissure or emphysematous parenchyma in the needle tract (p=0.001) and patient position (p=0.001). Conclusion: To minimize the risk of complications during FNAB, we recommend to avoid from lateral decubitus position and emphysematous parencyhma and fissures in the needle tract. We also recommend to prefer the shortest needle tract length.

Keywords

• Lung neoplasms
• image guided biopsy
• pneumothorax

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