Outpatient treatment of iatrogenic pneumothorax after needle biopsy.
OBJECTIVE
To evaluate prospectively the feasibility of treating iatrogenic pneumothorax after fine-needle aspiration biopsy (FNAB) of the lung with short-term placement of a small-caliber chest tube and to determine whether a 1-hour clamping trial is adequate to identify patients with persistent air leak.


METHODS
All patients undergoing FNAB of lung masses over a 28-month period were entered into the study. Patients with symptomatic, enlarging, or greater than 30% pneumothorax were treated with an 8-F chest tube. After 2 hours, the chest tube was clamped, and if the lung remained expanded for an additional hour, the chest tube was removed and the patients were discharged after a brief observation period. Patients were followed up by telephone after 24 hours.


RESULTS
Three hundred fifteen patients underwent FNAB of the lung. Sixty-eight patients (22%) developed a pneumothorax. Chest tubes were placed in 14 patients (4%): Six patients (2%) required admission to the hospital (four for air leaks), and the other eight patients were treated successfully as outpatients, with removal of the chest tube before discharge the day of FNAB.


CONCLUSIONS
Patients who develop clinically important pneumothorax after FNAB can be safely treated with short-term, small-caliber chest tubes and require hospital admission only if they demonstrate evidence of continued air leak.
Brown
K T
KT
Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, NY 10021, USA.
Brody
L A
LA
Getrajdman
G I
GI
Napp
T E
TE
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care; D001707:Biopsy, Needle / Q000009:adverse effects*; D015505:Chest Tubes; D002648:Child; D005260:Female; D006801:Humans; D008168:Lung / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011030:Pneumothorax / Q000209:etiology / Q000628:therapy*; D011446:Prospective Studies