Fifty-six cases and 56 controls were recruited.
The mean age of the sample was 66.1 ± 10.9 years.
The mean lesion size (maximum diameter) was 37.1 ± 25.6 mm.
The mean lesion depth (distance of lung crossed between the pleura and the lesion) was 14.3 ± 15.3 mm.
Primary tumours and metastases were more frequent in the right lung (54/93; 58.1% and 11/13; 84.6% respectively; P = 0.066).
Primary lung tumours and metastases showed a trend to present in different locations,
being primary lung tumors more frequent in upper lobes (54/93 -58.1%-) and metastasis in lower lobes,
medium lobe and lingulae,
conjointly (8/13-100%-; P = 0.183).
Primary lung adenocarcinoma was the most frequent histological diagnosis (32/112; 28.6%),
especially in the right upper lobe (13/32; 40.6%).
Lung complications related to biopsy procedure
Pneumothorax was diagnosed in 35/112 (31.3%) patients after lung biopsy (Fig. 5).
Alveolar haemorrhage was diagnosed in 9/112 (8%) patients after lung biopsy and hemoptysis in 6/112 (5.4%) patients.
Lung lobe and lesion depth did not increase the pneumothorax risk.
alveolar haemorrhage depended on the location,
being more frequent in upper left lobe lesions (5/9; 55.6%; P = 0.025; OR = 4.3; 95% confidence interval = 1.26 - 14.99).
deep lesions showed a trend to bleeding (22.33 ± 18.98 mm depth vs.
13.6 ± 14.6 mm; P = 0.12) (Fig. 6).
Impact of saline solution instillation through biopsy coaxial needle
Pneumothorax was less frequent (P = 0.025) with SSLB (12/56; 21.4%) than CoLB (23/56; 41.1%) (Fig. 7).These results are consistent with the results of the previous studies and show that the instillation of saline solution in the biopsy track after performing a pulmonary biopsy decreases significantly the incidence of pneumothorax [10-11].
no complications or saline solution instillation-related adverse events were observed.
Pneumothorax thickness (6.58 ± 5.99 for SSLB mm vs.
9.17 ± 4.60 for CoLB; P = 0.16) did not reach a significant difference.
Progressive pneumothorax increase was lesser for the patients who undergoing sealing technique,
but this tendency did not reach a significant difference neither (5.67 ± 4.72 mm; 0% equal or greater than 2 cm for SSLB,
vs. 15.90 ± 11.83 mm; 40% equal or greater than 2 cm for CoLB; P = 0.18) (Fig. 8).
No patient in the group of cases and one patient in control group developed large pneumothorax requiring chest tube placement.
According to the multivariate analysis,
SSLB was the only variable independently which decrease the pneumothorax rate (OR 2.48,
95% confidence interval = 1.03 - 5.96; P = 0.042).
Biopsy needle gauge,
added fine-needle aspiration,
lesion depth and lobe,
and lesion semiology were not related to pneumothorax risk after lung-biopsy.
Other variables influencing pneumothorax rate
Emphysema (P = 0.052) and increasing number of samples (P = 0.087) showed a risk trend for pneumothorax in the univariate analysis,
but it did not achieve a statistically significant difference on the multivariate analysis.