Pneumothorax as a complication of percutaneous radiofrequency ablation for lung neoplasms.
OBJECTIVE
The present study was performed to determine the frequency of the complication of pneumothorax after radiofrequency (RF) ablation for lung neoplasms and risk factors affecting such pneumothoraces.


METHODS
The study was based on 129 consecutive sessions of percutaneous RF ablation of lung neoplasms under real-time computed tomographic fluoroscopic guidance performed in a single institution between May 2003 and November 2005 in 41 patients (17 women, 24 men; mean age, 63 years; age range, 29-82 y). Correlation was determined between the incidence of pneumothorax after RF ablation and multiple factors: sex, age, presence of emphysema, lesion size, lesion depth, contact of tumor with pleura, number of punctures, maximum power of RF generator, period of ablation, tissue temperature at the end of the RF ablation session, and patient position during the procedure. Management of each case of iatrogenic pneumothorax was reviewed.


RESULTS
Pneumothorax after RF ablation occurred in 38 of 129 RF ablation sessions (29.5%). Fourteen of the 38 cases were treated by manual aspiration, and 24 were simply observed. In five cases (3.9%), chest tube placement was required as therapy for pneumothorax. The risk of pneumothorax was significantly increased in patients with pulmonary emphysema.


CONCLUSIONS
The frequency of pneumothorax after RF ablation in our experience is similar to the frequency of pneumothorax after lung biopsy reported in the literature. Various conditions for RF ablation did not influence the incidence of pneumothorax. Emphysema was the only individual factor that correlated significantly with the development of iatrogenic pneumothorax.
Yamagami
Takuji
T
Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-chyo, Kawaramachi-Hirokoji, Kamigyo, Kyoto 602-8566, Japan. yamagami@koto.kpu-m.ac.jp
Kato
Takeharu
T
Hirota
Tatsuya
T
Yoshimatsu
Rika
R
Matsumoto
Tomohiro
T
Nishimura
Tsunehiko
T
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017115:Catheter Ablation / Q000009:adverse effects*; D004646:Emphysema / Q000453:epidemiology; D005260:Female; D006801:Humans; D007049:Iatrogenic Disease; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011030:Pneumothorax / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D014057:Tomography, X-Ray Computed