Transbronchial biopsy from the upper pulmonary lobes is associated with increased risk of pneumothorax – a retrospective study
Abstract Background Pneumothorax (PTX) is one of the most common complications of transbronchial biopsy (TBB). Previous research suggests that upper pulmonary lobe TBB may be associated with increased risk of PTX development. The aim of this study was to compare the risk of PTX after TBB performed f...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2019-03-01
|
| Series: | BMC Pulmonary Medicine |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12890-019-0820-z |
| _version_ | 1818850914671263744 |
|---|---|
| author | Vladimir Herout Michaela Heroutova Zdenek Merta Ivan Cundrle Jr Kristian Brat |
| author_facet | Vladimir Herout Michaela Heroutova Zdenek Merta Ivan Cundrle Jr Kristian Brat |
| author_sort | Vladimir Herout |
| collection | DOAJ |
| description | Abstract Background Pneumothorax (PTX) is one of the most common complications of transbronchial biopsy (TBB). Previous research suggests that upper pulmonary lobe TBB may be associated with increased risk of PTX development. The aim of this study was to compare the risk of PTX after TBB performed from different pulmonary lobes. Methods All bronchoscopic records from the period January 1st, 2015 - December 31st, 2017 (from the Department of Respiratory Diseases, University Hospital Brno, Czech Republic) were retrospectively analyzed. Of the 3542 bronchoscopic records, 796 patients underwent TBB and were further analyzed. Basic demographic data, TBB procedure-related factors, smoking history and radiological features were analyzed. Furthermore, in patients who developed PTX, PTX onset, PTX symptoms, distribution of the abnormal radiological findings and duration of hospitalization were also analyzed. Results Patients who developed PTX had significantly lower body mass index (BMI) and more than 4 samples taken during procedure (all p < 0.05). TBB performed from the left upper pulmonary lobe was associated with a significant risk of PTX development (OR 2.27; 95% CI 1.18–4.35; p = 0.02). On the contrary, TBB performed from the right lower lobe was associated with a significant reduction of risk of developing PTX (OR 0.47; 95% CI 0.22–0.98; p = 0.04). Logistic regression analysis showed BMI (OR 1.08; 95% CI 1.02–1.16; p = 0.01), left upper lobe as sampling site (OR 2.15; 95% CI 1.13–4.11; p = 0.02) and more than 4 samples taken (OR 1.91; 95% CI 1.04–3.49; p = 0.04) to be significantly associated with PTX development. Conclusions We conclude that TBB from the left upper pulmonary lobe is associated with significantly increased risk of post-procedural PTX. The right lower pulmonary lobe seems to be the safest sampling site to perform TBB. In patients with diffuse-type pulmonary disease, TBB should be performed preferably from the right lower lobe in order to decrease the risk of post-procedural PTX. |
| first_indexed | 2024-12-19T06:56:42Z |
| format | Article |
| id | doaj.art-ca7a8983e05b486f8da038129ab5bb65 |
| institution | Directory Open Access Journal |
| issn | 1471-2466 |
| language | English |
| last_indexed | 2024-12-19T06:56:42Z |
| publishDate | 2019-03-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pulmonary Medicine |
| spelling | doaj.art-ca7a8983e05b486f8da038129ab5bb652022-12-21T20:31:31ZengBMCBMC Pulmonary Medicine1471-24662019-03-011911610.1186/s12890-019-0820-zTransbronchial biopsy from the upper pulmonary lobes is associated with increased risk of pneumothorax – a retrospective studyVladimir Herout0Michaela Heroutova1Zdenek Merta2Ivan Cundrle Jr3Kristian Brat4Department of Respiratory Diseases, University Hospital Brno and Faculty of Medicine, Masaryk UniversityDepartment of Respiratory Diseases, University Hospital Brno and Faculty of Medicine, Masaryk UniversityDepartment of Respiratory Diseases, University Hospital Brno and Faculty of Medicine, Masaryk UniversityDepartment of Anesthesiology and Intensive Care, St. Anne’s University Hospital and Faculty of Medicine, Masaryk UniversityDepartment of Respiratory Diseases, University Hospital Brno and Faculty of Medicine, Masaryk UniversityAbstract Background Pneumothorax (PTX) is one of the most common complications of transbronchial biopsy (TBB). Previous research suggests that upper pulmonary lobe TBB may be associated with increased risk of PTX development. The aim of this study was to compare the risk of PTX after TBB performed from different pulmonary lobes. Methods All bronchoscopic records from the period January 1st, 2015 - December 31st, 2017 (from the Department of Respiratory Diseases, University Hospital Brno, Czech Republic) were retrospectively analyzed. Of the 3542 bronchoscopic records, 796 patients underwent TBB and were further analyzed. Basic demographic data, TBB procedure-related factors, smoking history and radiological features were analyzed. Furthermore, in patients who developed PTX, PTX onset, PTX symptoms, distribution of the abnormal radiological findings and duration of hospitalization were also analyzed. Results Patients who developed PTX had significantly lower body mass index (BMI) and more than 4 samples taken during procedure (all p < 0.05). TBB performed from the left upper pulmonary lobe was associated with a significant risk of PTX development (OR 2.27; 95% CI 1.18–4.35; p = 0.02). On the contrary, TBB performed from the right lower lobe was associated with a significant reduction of risk of developing PTX (OR 0.47; 95% CI 0.22–0.98; p = 0.04). Logistic regression analysis showed BMI (OR 1.08; 95% CI 1.02–1.16; p = 0.01), left upper lobe as sampling site (OR 2.15; 95% CI 1.13–4.11; p = 0.02) and more than 4 samples taken (OR 1.91; 95% CI 1.04–3.49; p = 0.04) to be significantly associated with PTX development. Conclusions We conclude that TBB from the left upper pulmonary lobe is associated with significantly increased risk of post-procedural PTX. The right lower pulmonary lobe seems to be the safest sampling site to perform TBB. In patients with diffuse-type pulmonary disease, TBB should be performed preferably from the right lower lobe in order to decrease the risk of post-procedural PTX.http://link.springer.com/article/10.1186/s12890-019-0820-zPneumothoraxBronchoscopyTransbronchial biopsyUpper pulmonary lobePleural pressure |
| spellingShingle | Vladimir Herout Michaela Heroutova Zdenek Merta Ivan Cundrle Jr Kristian Brat Transbronchial biopsy from the upper pulmonary lobes is associated with increased risk of pneumothorax – a retrospective study BMC Pulmonary Medicine Pneumothorax Bronchoscopy Transbronchial biopsy Upper pulmonary lobe Pleural pressure |
| title | Transbronchial biopsy from the upper pulmonary lobes is associated with increased risk of pneumothorax – a retrospective study |
| title_full | Transbronchial biopsy from the upper pulmonary lobes is associated with increased risk of pneumothorax – a retrospective study |
| title_fullStr | Transbronchial biopsy from the upper pulmonary lobes is associated with increased risk of pneumothorax – a retrospective study |
| title_full_unstemmed | Transbronchial biopsy from the upper pulmonary lobes is associated with increased risk of pneumothorax – a retrospective study |
| title_short | Transbronchial biopsy from the upper pulmonary lobes is associated with increased risk of pneumothorax – a retrospective study |
| title_sort | transbronchial biopsy from the upper pulmonary lobes is associated with increased risk of pneumothorax a retrospective study |
| topic | Pneumothorax Bronchoscopy Transbronchial biopsy Upper pulmonary lobe Pleural pressure |
| url | http://link.springer.com/article/10.1186/s12890-019-0820-z |
| work_keys_str_mv | AT vladimirherout transbronchialbiopsyfromtheupperpulmonarylobesisassociatedwithincreasedriskofpneumothoraxaretrospectivestudy AT michaelaheroutova transbronchialbiopsyfromtheupperpulmonarylobesisassociatedwithincreasedriskofpneumothoraxaretrospectivestudy AT zdenekmerta transbronchialbiopsyfromtheupperpulmonarylobesisassociatedwithincreasedriskofpneumothoraxaretrospectivestudy AT ivancundrlejr transbronchialbiopsyfromtheupperpulmonarylobesisassociatedwithincreasedriskofpneumothoraxaretrospectivestudy AT kristianbrat transbronchialbiopsyfromtheupperpulmonarylobesisassociatedwithincreasedriskofpneumothoraxaretrospectivestudy |