Evaluation of Major Complications Associated with Percutaneous CT-guided Biopsy of Lung Nodules Below 3 cm.

BACKGROUND/AIM: The aim of this study was to retrospectively evaluate the incidence and risk factors for the serious complications of pneumothorax and/or parenchymal hemorrhage occurring after computed tomography (CT) guided transthoracic biopsy. MATERIALS AND METHODS: The relation between the incidence of pneumothorax and parenchymal hemorrhage due to biopsy, and age, sex, lesion localization, lesion size, duration of the procedure, depth of lesion, number of pleural insertions of the biopsy needle and pathology results were statistically evaluated. RESULTS: Between 2016 and 2017, 309 cases with lesions below 3 centimeters in diameter of a total of 768 (40.2%) CT-guided chest biopsy patients were selected for retrospective review. The rate of pneumothorax and parenchymal hemorrhage was 18.1% (59/309) and 51% (158/309), respectively post biopsy. The number of needle pleural insertions correlated with the development of pneumothorax (p=0.002). At regression analysis, for parenchymal hemorrhage, lesion depth (p<0.001) and total procedure time (p=0.036) were determined as the most important independent risk factors. CONCLUSION: Pneumothorax and parenchymal hemorrhage are common complications after CT-guided percutaneous biopsy. The minimum number of needle-pleural insertions, the optimal access route to the lesion and as quick as possible biopsy procedure should be selected to reduce the risk of pneumothorax and parenchymal hemorrhage.