Efficacy of Normal Saline for Sealing the Needle Tract to Reduce Pneumothorax Incidence after Transthoracic Needle Lung Biopsies
คำสำคัญ:
Lung Biopsy, , TTNB, , Transthoracic Needle Biopsy,, Pneumothorax, , Normal Saline Tract Embolizationบทคัดย่อ
Background: Pneumothorax is a frequent complication of transthoracic needle biopsy (TTNB) procedures, often necessitating chest tube placement and hospitalization. The demand for lung biopsies is increasing due to the rising incidence of lung cancer and the identification of asymptomatic lung nodules, escalating the economic burden associated with complex lung biopsy procedures. Various techniques have been explored to reduce pneumothorax incidences in TTNB, including rapid rollover, autologous blood patch, fibrin gel plug, and normal saline sealant. However, there is no consensus on the most effective method.
Objective: The study evaluates the benefit of employing normal saline solution (NSS) tract embolization to reduce iatrogenic pneumothorax.
Material and method: This descriptive retrospective study was conducted at Vachira Phuket Hospital from January 2021 to September 2023. A total of 64 patients undergoing lung biopsies with and without NSS were compared. In the NSS group, 1-3 ml of normal saline was injected while withdrawing the coaxial sheath after the biopsy.
Result: Post-biopsy outcomes revealed a slight reduction in pneumothorax rates in the NSS group (18.8%, 6/32 patients) compared to the control group (31.2%, 10/32 patients), but this difference was not statistically significant (P=0.693). The need for pneumothorax chest drain (PCD) placement was marginally lower in the NSS group (3.1%, 1/32 patients) than in the control group (9.4%, 3/32 patients), indicating chest tube insertion in cases of severe pneumothorax (more than 4 cm in CXR measurement) or if the patient developed dyspnea. However, this difference did not reach statistical significance (P=0.613).
Conclusion: While the NSS group exhibited a trend towards lower pneumothorax rates and decreased chest tube insertions post-biopsy, these differences did not reach statistical significance. Further research with larger sample sizes and refined methodologies, such as randomized controlled trials, is warranted to elucidate the role of NSS in TTNB procedures.
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