Perkütan akciğer iğne biyopsisi: teknik, komplikasyonlar ve tanısal etkinlik

Emrah Akay; Sergen Mısırlı; Gülen Demirpolat; Nurhan Sarıoğlu; Serpil Paksoy; Erdoğan Bülbül; Bahar Yanık

doi:10.19161/etd.1262552

EN TR

Percutaneous lung needle biopsy: technique, complications and diagnostic accuracy

Abstract

Aim: Imaging-guided transthoracic biopsy procedures are preferred by clinicians as they can be performed under local anesthesia and have a low complication risk. In our study, we aimed to investigate the technical and diagnostic success rates of percutaneous lung biopsies performed under the guidance of computerized tomography (CT) and ultrasonography (US), complications, and possible reasons for increasing the complication rates and compare the results with the studies in the literature. Materials and Methods: Eighty-seven patients underwent US-guided, and 31 patients underwent CTguided percutaneous lung biopsy. The files and radiological images of these patients were scanned retrospectively. The size and location of the lesions, the trans-parenchymal distance crossed during the procedure, needle type, complications, histopathological results, procedure times, and procedure costs were noted. Results: Diagnostic success rates in US and CT guided biopsies were calculated as 91.9% and 77.4%, respectively. No complications developed in 85 of 87 patients who underwent US-guided fine needle (FNAB) (n:33) and cutting needle biopsy (Tru-Cut) (n:54). Pneumothorax was observed in one patient and hemothorax was observed in one patient. Pneumothorax was found in 14 of the patients who underwent CT-guided biopsy, and parenchymal hemorrhage was found in 2 of them. A specific diagnosis could be made for 104 (88.1%) lesions. Significantly lower complication rates were found in US-guided procedures compared to CT-guided biopsy procedures (p<0.001). No correlation was found between the development of complications and the demographic characteristics of the patients, lesion size, localization, and trans-parenchymal distance (p>0.05). Complications were found to be lower in pleural-based lesions compared to parenchymal lesions (p<0.001). Conclusion: US and CT-guided needle biopsies of lung lesions are procedures with high technical and diagnostic success and low major complication rates. In case of appropriate lesion localization, US-guided biopsy procedures have high diagnostic success, low complication risk, shorter duration and lower cost compared to CT-guided biopsy procedures.

Keywords

Perkütan akciğer iğne biyopsisi: teknik, komplikasyonlar ve tanısal etkinlik

Öz

Amaç: Görüntüleme rehberliğinde yapılan transtorasik biyopsi işlemleri, lokal anestezi ile yapılabilmesi ve düşük komplikasyon riski nedeni ile klinisyenler tarafından tercih edilmektedir. Çalışmamızda bilgisayarlı tomografi (BT) ve ultrasonografi (US) rehberliğinde yapılan perkütan akciğer biyopsilerinin teknik ve tanısal başarı oranlarını, komplikasyonlarını ve komplikasyonu arttıran olası sebepleri araştırmayı ve literatürdeki çalışmalar ile karşılaştırmayı amaçladık. Gereç ve Yöntem: Seksenyedi hastaya US, 31 hastaya BT rehberliğinde perkütan akciğer biyopsisi yapılmış olup bu hastaların dosyaları ve radyolojik görüntüleri retrospektif olarak taranmıştır. Lezyonların boyutu, yerleşimi ve işlem sırasında geçilen transparankimal mesafe, iğne tipi, gelişen komplikasyonlar, histopatolojik sonuçlar, işlem süreleri ve maliyetleri not edilmiştir. Bulgular: US ve BT rehberliğinde yapılan biyopsilerde tanısal başarı oranları sırası ile %91,9 ve %77,4 olarak hesaplanmıştır. US rehberliğinde ince iğne biyopsisi (İİAB) (n:33) ve kesici iğne biyopsisi (Tru-Cut) (n:54) yapılan 87 hastanın 85’inde komplikasyon gelişmemiştir. Bir hastada pnömotoraks, 1 hastada hematoraks gözlenmiştir. BT rehberliğinde biyopsi yapılan hastaların 14’ünde pnömotoraks, 2’ sinde parankimal kanama saptanmıştır. Yüz dört (%88,1) lezyona spesifik tanı koyulabilmiştir. US rehberliğinde yapılan biyopsi işlemlerinde, BT rehberliğinde yapılan işlemlere göre belirgin olarak düşük komplikasyon oranları saptanmıştır (p<0,001). Komplikasyon gelişimi ile hastaların demografik özellikleri, lezyon boyutu, lokalizasyonu transparankimal mesafe arasında korelasyon saptanmamıştır(p>0,05). Plevral tabanlı lezyonlarda, parankimal yerleşimli lezyonlara göre komplikasyon gelişme olasılığı daha düşük bulunmuştur (p<0,001). Sonuç: Akciğer lezyonlarının US ve BT rehberliğinde iğne biyopsileri teknik ve tanısal başarısı yüksek, majör komplikasyon oranı düşük işlemlerdir. Uygun lezyon yerleşimi durumunda US rehberliğinde yapılan biyopsi işlemleri tanısal başarısı yüksek, komplikasyon riski düşük, BT rehberliğinde yapılan biyopsi işlemlerine göre daha kısa süreli ve düşük maliyetli uygulamalardır.

Anahtar Kelimeler

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Details

Primary Language

Turkish

Subjects

Health Care Administration

Journal Section

Research Article

Authors

Emrah Akay ^*
Türkiye

Sergen Mısırlı
Türkiye

Gülen Demirpolat
Türkiye

Nurhan Sarıoğlu
Türkiye

Serpil Paksoy
Türkiye

Erdoğan Bülbül
Türkiye

Bahar Yanık
Türkiye

Publication Date

March 15, 2023

Submission Date

April 25, 2022

Acceptance Date

January 12, 2023

Published in Issue

Year 2023 Volume: 62 Number: 1

DOI

https://doi.org/10.19161/etd.1262552

IZ

https://izlik.org/JA66AY54FW

Cite

RIS / Bibtex

Vancouver

1.Emrah Akay, Sergen Mısırlı, Gülen Demirpolat, Nurhan Sarıoğlu, Serpil Paksoy, Erdoğan Bülbül, Bahar Yanık. Perkütan akciğer iğne biyopsisi: teknik, komplikasyonlar ve tanısal etkinlik. EJM. 2023 Mar. 1;62(1):125-33. doi:10.19161/etd.1262552