Risk Factors of Pneumothorax after Endobronchial Ultrasound-Guided Transbronchial Biopsy for Peripheral Lung Lesions 英文参考文献.docVIP

RiskFactorsofPneumothoraxafterEndobronchial Ultrasound-GuidedTransbronchialBiopsyforPeripheral LungLesions Chun-TaHuang1,2,Sheng-YuanRuan1,5,Wei-YuLiao1,Yao-WenKuo3,Chi-YingLin3,Yi-JuTsai4 ,Chao- ChiHo1*,Chong-JenYu1 1Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan, 2Department of Traumatology, National Taiwan University Hospital, Taipei, Taiwan,3DepartmentofInternalMedicine,NationalTaiwanUniversityHospital,Yun-LinBr.,Yunlin,Taiwan,4SchoolofMedicine,CollegeofMedicine,Fu-JenCatholic University,Taipei,Taiwan,5GraduateInstituteofEpidemiologyandPreventiveMedicine,NationalTaiwanUniversity,Taipei,Taiwan Abstract Background:Theriskofendobronchialultrasound-guidedtransbronchialbiopsy-relatedpneumothoraxisamajorconcern and warrants further studies. The aim of our study was to estimate the risk of pneumothorax after this procedure and identifyitsriskfactors. Methods: From 2007 to 2011, 399 patients who underwent endobronchial ultrasound-guided transbronchial biopsy for peripheral lung lesions were included in this study. The variables analyzed included patient factors, lesion factors and procedurefactors.Multivariatelogisticregressionanalysiswasusedtoidentifyindependentriskfactorsforpneumothorax. Results: The incidence of pneumothorax was 3.3% (13/399). Chest tube placement was required for 31% (4/13) of pneumothoraces. Independent risk factors for pneumothorax included pulmonary emphysema (OR, 55.09; 95% CI, 9.37– 324.03; p,0.001) and probe position adjacent to the lesion (OR, 17.01; 95% CI, 2.85–101.64; p=0.002). The number of biopsyspecimens,age,sex,historyofpriorlungsurgeryandlesionsize,locationandcharacterdidnotinfluencetheriskof pneumothoraxinouranalyses. Conclusions: The risk of pneumothorax after endobronchial ultrasound-guided transbronchial biopsy is low. To further reducetheriskofpneumothorax,everyeffortshouldbemadetoadvancetheendobronchialultrasoundprobeintothe bronchuswhereitisimagedwithinthetargetlesionbeforeembarkingontran