Akciğer içindeki iğne manevrası sayısının ve plevral ponksiyon sayısının, akciğer transtorasik çekirdek iğne biyopsisinin bir komplikasyonu olan pnömotoraks oluşumuna etkisi

Yıl 2020, Cilt: 10 Sayı: 2, 231 - 236, 25.06.2020

Bekir Turgut , Ferdane Melike Duran Fatih Öncü , Hıdır Esme

https://doi.org/10.16899/jcm.731924

Öz

Amaç
Bu çalışmada BT eşliğinde transtorasik çekirdek iğne biyopsisinde, iğne manevrası sayısı ve plevral ponksiyon sayısının pnömotoraks üzerine etkisini araştırmak amaçlandı.
Yöntem
Hastalara uygulanan BT eşliğinde çekirdek iğne biyopsisi kayıtları retrospektif olarak incelendi. Demografik veriler, işlem raporları, patoloji raporları, tomografi görüntüleri, takip muayeneleri ve biyopsiye bağlı komplikasyonlar incelendi. Daha sonra, iğnenin plevraya kaç kez girdiği ve akciğerdeki manevra sayısı listelenmiştir. Plevral ponksiyon sayısı 1 veya ≥2 olarak kaydedildi. İğne manevra sayısı 1, 2 veya ≥3 olarak kaydedildi. Listelenen tüm değişkenler istatistiksel olarak değerlendirildi.
Bulgular
Toplamda 393 hasta çalışmaya dahil edildi. Pnömotoraks komplikasyonu 87(%22,1) hastada oldu. Pnömotoraksa bağlı toraks tüpü uygulaması 39(%9,9) hastada gerekli oldu.
Biyopsi uygulama esnasındaki akciğerlerdeki iğne manevrası sayısının 3+ olduğu durumlarda, pnömotoraks insidansında ve toraks tüpü uygulama gereksiniminde artış saptandı (p=0.001). Lezyon boyutu azaldıkça ve lezyon plevra mesafesi arttıkça iğnenin akciğer içerisindeki manevra sayısı artmıştır (p=0.001, p=0.008). Plevra delinme sayısı ≥2 olan 48 hastada, pnömotoraks ve toraks tüpü uygulama oranları artmıştır (p=0.001, p=0.001).
Sonuç
BT eşliğinde yapılan pulmoner transtorasik çekirdek iğne biyopsisi uygulamalarında, iğne manevrası sayısı ve plevral ponksiyon sayısı pnömotoraks gelişme riskine katkıda bulunan ana faktörleri oluşturmaktadır.

Anahtar Kelimeler

pnömotoraks, akciğer kanseri, transtorasik biyopsi, akciğer biyopsisi

The effect of the number of needle maneuver in the lung and the number of pleural punctures on the formation of pneumothorax, a complication of lung transthoracic core needle biopsy

Öz

Aim
This study sought to investigate the effect of the needle maneuver count and number of pleural punctures on pneumothorax in CT-guided transthoracic core needle biopsy.
Materials and Methods
Records of CT-guided core needle biopsy performed on patients were retrospectively reviewed. Demographic data, procedure reports, pathology reports, tomography images, follow-up examinations, and complications due to biopsy were examined. Next, the number of times the needle penetrated the pleura and the number of maneuvers in the lung were listed. The number of pleural punctures was recorded either as 1 or ≥2. The needle maneuver count was recorded either as 1, 2, or ≥3. All listed variables were statistically evaluated.
Results
A total of 393 patients were included in the study. Complications of pneumothorax occurred in 87 (22.1%) patients. A thorax tube application due to pneumothorax was required in 39 (9.9%) patients.
When the needle maneuver count in the lungs during biopsy was greater than 3, the incidence of pneumothorax and the need for a thorax tube application were increased (p = 0.001). As the size of the lesion decreased and the lesion-pleura distance increased, the needle maneuver count in the lung increased (p = 0.001, p = 0.008). Pneumothorax and thorax tube application rates were increased in 48 patients with pleural punctures ≥2 (p = 0.001, p = 0.001).
Conclusion
In CT-guided pulmonary transthoracic core needle biopsy applications, needle maneuver count and the number of pleural punctures constitute the major factors contributing to the risk of developing pneumothorax.

Anahtar Kelimeler

pneumothorax, lung cancer, transthoracic biopsy, lung biopsy

Kaynakça

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