Our Summary

This study looked at the effects of a procedure called intraparenchymal blood patching (IBP) on the risk of lung collapse (pneumothorax) after a lung biopsy, where a small piece of lung tissue is removed for testing. The researchers also looked at how the size and location of the lung tumor, the thickness of the needle used, the number of samples taken, and the experience of the doctor performing the procedure might affect this risk.

The study involved looking back at 868 lung biopsies performed at one institution between 2003 and 2018. Nearly half of the patients had received an IBP.

The results showed that the rate of lung collapse was significantly lower in the group that received an IBP compared to the group that did not. The number of patients needing a chest tube after the procedure (to help re-inflate the lung) was also lower in the IBP group, but this difference was not significant.

The study also found that the risk of lung collapse was lower for larger tumors, but increased the deeper the tumor was located in the lung. The risk was also lower when a 17 gauge needle was used in combination with an IBP, and when the biopsy was taken from the lower part of the lung.

The risk of lung collapse was lower when more than four tissue samples were taken and when the procedure was performed by an experienced doctor.

In conclusion, the study suggests that IBP can significantly reduce the risk of lung collapse following a lung biopsy, particularly for deeper tumors, when more samples are needed, when the doctor is less experienced, and when the biopsy is taken from the lower part of the lung.

FAQs

  1. What is intraparenchymal blood patching (IBP) and how does it affect the risk of lung collapse after a lung biopsy?
  2. What factors were found to affect the risk of lung collapse after a lung biopsy according to the study?
  3. Does the study suggest that an experienced doctor performing the biopsy reduces the risk of lung collapse?

Doctor’s Tip

A doctor might advise a patient undergoing a lung biopsy to ask about the possibility of receiving an intraparenchymal blood patch (IBP) to reduce the risk of lung collapse. They may also recommend using a 17 gauge needle, taking more than four tissue samples, and ensuring the procedure is performed by an experienced doctor. Additionally, patients should be aware that the risk of lung collapse may be lower for larger tumors and when the biopsy is taken from the lower part of the lung.

Suitable For

Patients who may be recommended for a lung biopsy include those with suspected lung cancer, lung nodules, lung infections, interstitial lung disease, or other lung abnormalities that require further evaluation. These patients may have symptoms such as coughing, chest pain, shortness of breath, or unexplained weight loss. Additionally, patients with a history of smoking, exposure to environmental toxins, or a family history of lung cancer may also be recommended for a lung biopsy.

Timeline

Overall, the timeline of a patient’s experience before and after a lung biopsy may look like this:

Before the biopsy:

  1. Patient undergoes a pre-operative evaluation to assess their overall health and suitability for the procedure.
  2. Patient may undergo imaging tests (such as CT scans) to locate the tumor and plan the biopsy.
  3. Patient may receive instructions on fasting before the procedure and any necessary medications.
  4. Consent form is signed by the patient, detailing the risks and benefits of the procedure.

During the biopsy:

  1. Patient is positioned on their side or back, depending on the location of the tumor.
  2. Local anesthesia is administered to numb the area where the biopsy will be performed.
  3. A needle or biopsy instrument is inserted through the chest wall to obtain a tissue sample.
  4. The patient may be asked to hold their breath for a few seconds during the procedure.
  5. Multiple samples may be taken if needed.

After the biopsy:

  1. Patient is monitored for a period of time after the procedure to check for any immediate complications.
  2. Patient may experience some pain or discomfort at the biopsy site, which can be managed with pain medications.
  3. Patient may be advised to avoid strenuous activities for a certain period of time.
  4. Results of the biopsy are sent to the doctor for interpretation, which may take a few days.
  5. If a pneumothorax occurs, the patient may need a chest tube inserted to re-inflate the lung.
  6. Follow-up appointments are scheduled to discuss the biopsy results and plan for further treatment if needed.

What to Ask Your Doctor

Some questions a patient should ask their doctor about lung biopsy include:

  1. What is the likelihood of experiencing a lung collapse (pneumothorax) after the biopsy?
  2. Will I be receiving an intraparenchymal blood patch (IBP) to reduce the risk of lung collapse?
  3. How many tissue samples will be taken during the biopsy, and does this affect the risk of complications?
  4. What size and thickness of needle will be used during the biopsy, and how does this impact the risk of lung collapse?
  5. Where is the tumor located in my lung, and how does this affect the risk of complications?
  6. How experienced is the doctor who will be performing the biopsy, and does this impact the risk of complications?
  7. What are the potential symptoms of a lung collapse that I should watch out for after the procedure?
  8. What is the plan for managing any complications that may arise during or after the biopsy?
  9. Are there any alternative procedures or techniques that could be considered to reduce the risk of complications?
  10. What are the potential long-term effects or risks associated with undergoing a lung biopsy?

Reference

Authors: Perl RM, Risse E, Hetzel J, Bösmüller H, Kloth C, Fritz J, Horger M. Journal: Eur J Radiol. 2019 Jul;116:14-20. doi: 10.1016/j.ejrad.2019.04.010. Epub 2019 Apr 19. PMID: 31153555