Factors influencing pneumothorax rates of transthoracic CT-guided lung biopsies in a Tertiary centre in Cape Town, South Africa

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dc.contributor.advisorSaid-Hartley, Qonita
dc.contributor.authorRichards-Edwards, William H
dc.date.accessioned2021-09-15T09:51:43Z
dc.date.available2021-09-15T09:51:43Z
dc.date.issued2020
dc.date.updated2021-09-15T08:32:44Z
dc.description.abstractBackground: Histological sampling of pulmonary lesions is important in diagnosis of lung carcinoma and affects subsequent decisions on specific management. Transthoracic CT-guided lung biopsy is considered an effective option to obtain tissue with low rates of complications, with pneumothorax being the most common. Objectives: To determine the pneumothorax rate of transthoracic CT-guided lung biopsies of focal lung lesions at Groote Schuur Hospital, and assess how procedural, patient and lesion factors influence these results. Methods: A retrospective review of 237 CT-guided lung biopsies performed over a 24-month period. Patient's CT, biopsy reports and post-procedure x-rays were reviewed. The relationship between pneumothorax rates and categorical demographic and clinical variables was analysed with Cochran's trend test. Mann-Whitney U tests were used to assess differences in continuous variables. Factors influencing pneumothorax rates of transthoracic CT-guided lung biopsies in a Tertiary Centre in Cape Town, South Africa. Results: Pneumothorax occurred in 43 (18.1%) of the 237 biopsies. A chest drain was required in 7 of 43 pneumothoraces (16%; 3% overall). Risk factors that were significantly associated with pneumothorax rate include pleural-lesion distance (p<0.001), smaller lesion size (p=0.002), smaller needle gauge (p=0.012) and perilesional emphysema (p=0.011). Patient age, sex, position, lesion location and level of experience of the performing radiologist had no significant influence on the pneumothorax rate. Conclusion: Our post-procedure pneumothorax rate is within the acceptable range when compared to other institutions. Pleural-lesion distance, lesion size, smaller needle gauge and presence of perilesional emphysema were the most significant risk factors influencing pneumothorax rate. Knowledge of these findings may be applicable in pre-procedure planning to reduce complications and useful to local referring clinicians and patients.
dc.identifier.apacitationRichards-Edwards, W. H. (2020). <i>Factors influencing pneumothorax rates of transthoracic CT-guided lung biopsies in a Tertiary centre in Cape Town, South Africa</i>. (). ,Faculty of Health Sciences ,Division of Radiology. Retrieved from http://hdl.handle.net/11427/33903en_ZA
dc.identifier.chicagocitationRichards-Edwards, William H. <i>"Factors influencing pneumothorax rates of transthoracic CT-guided lung biopsies in a Tertiary centre in Cape Town, South Africa."</i> ., ,Faculty of Health Sciences ,Division of Radiology, 2020. http://hdl.handle.net/11427/33903en_ZA
dc.identifier.citationRichards-Edwards, W.H. 2020. Factors influencing pneumothorax rates of transthoracic CT-guided lung biopsies in a Tertiary centre in Cape Town, South Africa. . ,Faculty of Health Sciences ,Division of Radiology. http://hdl.handle.net/11427/33903en_ZA
dc.identifier.ris TY - Master Thesis AU - Richards-Edwards, William H AB - Background: Histological sampling of pulmonary lesions is important in diagnosis of lung carcinoma and affects subsequent decisions on specific management. Transthoracic CT-guided lung biopsy is considered an effective option to obtain tissue with low rates of complications, with pneumothorax being the most common. Objectives: To determine the pneumothorax rate of transthoracic CT-guided lung biopsies of focal lung lesions at Groote Schuur Hospital, and assess how procedural, patient and lesion factors influence these results. Methods: A retrospective review of 237 CT-guided lung biopsies performed over a 24-month period. Patient's CT, biopsy reports and post-procedure x-rays were reviewed. The relationship between pneumothorax rates and categorical demographic and clinical variables was analysed with Cochran's trend test. Mann-Whitney U tests were used to assess differences in continuous variables. Factors influencing pneumothorax rates of transthoracic CT-guided lung biopsies in a Tertiary Centre in Cape Town, South Africa. Results: Pneumothorax occurred in 43 (18.1%) of the 237 biopsies. A chest drain was required in 7 of 43 pneumothoraces (16%; 3% overall). Risk factors that were significantly associated with pneumothorax rate include pleural-lesion distance (p<0.001), smaller lesion size (p=0.002), smaller needle gauge (p=0.012) and perilesional emphysema (p=0.011). Patient age, sex, position, lesion location and level of experience of the performing radiologist had no significant influence on the pneumothorax rate. Conclusion: Our post-procedure pneumothorax rate is within the acceptable range when compared to other institutions. Pleural-lesion distance, lesion size, smaller needle gauge and presence of perilesional emphysema were the most significant risk factors influencing pneumothorax rate. Knowledge of these findings may be applicable in pre-procedure planning to reduce complications and useful to local referring clinicians and patients. DA - 2020_ DB - OpenUCT DP - University of Cape Town KW - Radiodiagnosis LK - https://open.uct.ac.za PY - 2020 T1 - Factors influencing pneumothorax rates of transthoracic CT-guided lung biopsies in a Tertiary centre in Cape Town, South Africa TI - Factors influencing pneumothorax rates of transthoracic CT-guided lung biopsies in a Tertiary centre in Cape Town, South Africa UR - http://hdl.handle.net/11427/33903 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/33903
dc.identifier.vancouvercitationRichards-Edwards WH. Factors influencing pneumothorax rates of transthoracic CT-guided lung biopsies in a Tertiary centre in Cape Town, South Africa. []. ,Faculty of Health Sciences ,Division of Radiology, 2020 [cited yyyy month dd]. Available from: http://hdl.handle.net/11427/33903en_ZA
dc.language.rfc3066eng
dc.publisher.departmentDivision of Radiology
dc.publisher.facultyFaculty of Health Sciences
dc.subjectRadiodiagnosis
dc.titleFactors influencing pneumothorax rates of transthoracic CT-guided lung biopsies in a Tertiary centre in Cape Town, South Africa
dc.typeMaster Thesis
dc.type.qualificationlevelMasters
dc.type.qualificationlevelMMed
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