Efficacy and Safety of 20G vs. 22G Needles in CT-Guided Transthoracic Fine Needle Aspiration Biopsies

Yıl 2024, Sayı: 23, 571 - 584, 31.08.2024

İlhan Nahit Mutlu , Burcu Özcan , Ali Dablan , Mehmet Cingöz , Tevfik Güzelbey , Özgür Kılıçkesmez

Öz

Aim: This study aims to compare the diagnostic accuracy and complication rates of 20G and 22G needles in transthoracic fine needle aspiration biopsy (TFNAB).
Method: This retrospective study reviewed lung biopsy results from procedures performed between January 2018 and March 2020. Patients included had non-diagnostic bronchoscopic biopsies or were deemed inappropriate for bronchoscopic biopsy. A total of 127 patients underwent Computed tomography (CT) guided TFNAB using either 20G or 22G needles. Data on lesion size, localization, diagnostic adequacy, and complications were collected and analyzed.
Results: The study cohort included 127 patients with a mean age of 63.21 years. Of these, 72 underwent biopsies with a 22G needle and 55 with a 20G needle. The overall diagnostic accuracy was 96.8%, with no significant differences between the 20G and 22G needle groups (p=0.206). Complications occurred in 59 patients (46.5%), with pneumothorax being the most common, and two cases required chest tube placement. The rate of pulmonary hemorrhage was 18.9%. There were no significant differences in complication rates between the needle sizes (p=0.985).
Conclusion: CT-guided TFNAB using both 20G and 22G needles is safe and effective, with high diagnostic accuracy and low complication rates. The choice of needle size does not significantly impact diagnostic outcomes or complication rates, allowing clinicians flexibility based on patient-specific factors and procedural requirements.

Anahtar Kelimeler

Biopsy, pneumothorax, computed tomography, transthoracic biopsy, fine-needle aspiration biopsy, diagnostic accuracy, complications, lung mass, needle gauge

20G ve 22G İğnelerin BT Kılavuzluğunda Transtorasik İnce İğne Aspirasyon Biyopsisinde Etkinliği ve Güvenliği

Öz

Amaç: Bu çalışma, transtorasik ince iğne aspirasyon biyopsisinde (TTİİAB) 20G ve 22G iğnelerin tanısal doğruluk ve komplikasyon oranlarını karşılaştırmayı amaçlamaktadır.
Yöntem: Bu retrospektif çalışmada, Ocak 2018 ile Mart 2020 arasında bilgisayarlı tomografi (BT) eşliğinde gerçekleştirilen transtorasik akciğer biyopsisi sonuçları incelendi. Toplamda 127 hastaya BT kılavuzluğunda TTİİAB kullanılarak 20G veya 22G iğnelerle biyopsi yapıldı. Biyopsi yapılan olgularda lezyon boyutu, lokalizasyonu, tanısal yeterlilik ve komplikasyonlar hakkında veriler toplandı ve analiz edildi.
Bulgular: Çalışmaya dahil edilen hastaların yaş ortalaması 63,21 yıl olup, toplamda 127 hasta mevcuttu. Bu hastalardan 72'sine 22G iğne ile, 55'ine ise 20G iğne ile biyopsi yapıldı. Genel tanısal doğruluk %96,8 olup, 20G ve 22G iğne grupları arasında tanısal doğruluk açısından anlamlı fark bulunmamıştır (p=0,206). Komplikasyonlar 59 hastada (%46,5) görülmüş olup, en yaygın komplikasyon pnömotorakstır. Pnömotoraks oranı %22,8 olup, iki vakada göğüs tüpü yerleştirilmiştir. İkinci en sık komplikasyon pulmoner hemoraji olup, %18,9 oranında görülmüştür. İğne boyutları arasında komplikasyon oranları açısından anlamlı bir fark bulunmamıştır (p=0,985).
Sonuç: BT kılavuzluğunda TTİİAB, 20G ve 22G iğneler kullanılarak güvenli ve etkili şekilde gerçekleştirilebilmekte olup, yüksek tanısal doğruluk ve düşük komplikasyon oranlarına sahiptir. İğne boyutu seçimi, tanısal sonuçları veya komplikasyon oranlarını etkilememektedir.

Anahtar Kelimeler

Biyopsi, pnömotoraks, bilgisayarlı tomografi, transtorasik biyopsi, ince iğne aspirasyon biyopsisi, tanısal doğruluk, komplikasyonlar, akciğer kitlesi, iğne boyutu

Kaynakça

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