title: Subinterlobular Pleural Location Is a Risk Factor for Pneumothorax After Bronchoscopy.
abstract: BACKGROUND
  Pneumothorax is one of the most important complications after bronchoscopy. This study was conducted to determine the risk factors for post-bronchoscopy pneumothorax.
  
  
  METHODS
  We retrospectively reviewed the medical records of 23 consecutive subjects who were diagnosed with iatrogenic pneumothorax after bronchoscopy between August 2010 and February 2014. Forty-six control subjects who did not develop pneumothorax after bronchoscopy were randomly selected. The factors affecting the occurrence of pneumothorax were determined by univariate and multivariate analyses.
  
  
  RESULTS
  Among 991 patients who underwent bronchoscopy during the study period, 23 (2.3%) developed pneumothorax after bronchoscopy. Among these 23 subjects, 13 (57%) required chest tube drainage. Compared with the control group (46 randomly selected from 968 subjects who did not develop pneumothorax), the group that developed pneumothorax had a preponderance of women and had more target lesions located in the subpleural area (odds ratio [OR] 7.8, 95% CI 0.9-64), especially those that were close to the interlobular pleura (OR 5.1, 95% CI 1.6-16.1) and the left lung (OR 3.2, 95% CI 1.1-9.5). Multivariate analysis revealed that a subinterlobular pleural location of a lesion was a risk factor for pneumothorax (OR 4.8, 95% CI 1.1-20.4).
  
  
  CONCLUSIONS
  Pneumothorax occurred significantly more frequently when bronchoscopy was performed for subinterlobular pleural lesions. Close attention and care should be taken during bronchoscopy, especially when target lesions are abutting the interlobular pleura.
authors.affiliation: Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan. hchino-tky@umin.ac.jp.|Department of Respiratory Medicine, University of Tokyo Hospital, Tokyo, Japan.
authors.forename: Haruka
authors.initials: H
authors.lastname: Chino
authors.affiliation: Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan.
authors.forename: Motoyasu
authors.initials: M
authors.lastname: Iikura
authors.affiliation: Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan.
authors.forename: Nayuta
authors.initials: N
authors.lastname: Saito
authors.affiliation: Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan.
authors.forename: Nahoko
authors.initials: N
authors.lastname: Sato
authors.affiliation: Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan.
authors.forename: Manabu
authors.initials: M
authors.lastname: Suzuki
authors.affiliation: Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan.
authors.forename: Satoru
authors.initials: S
authors.lastname: Ishii
authors.affiliation: Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan.
authors.forename: Eriko
authors.initials: E
authors.lastname: Morino
authors.affiliation: Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan.
authors.forename: Go
authors.initials: G
authors.lastname: Naka
authors.affiliation: Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan.
authors.forename: Jin
authors.initials: J
authors.lastname: Takasaki
authors.affiliation: Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan.
authors.forename: Shinyu
authors.initials: S
authors.lastname: Izumi
authors.affiliation: Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan.
authors.forename: Masayuki
authors.initials: M
authors.lastname: Hojo
authors.affiliation: Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan.
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Takeda
authors.affiliation: Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan.
authors.forename: Haruhito
authors.initials: H
authors.lastname: Sugiyama
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001999:Bronchoscopy / Q000009:adverse effects* / Q000379:methods; D016022:Case-Control Studies; D015505:Chest Tubes / Q000009:adverse effects; D004322:Drainage / Q000009:adverse effects / Q000379:methods; D005260:Female; D006801:Humans; D008168:Lung / Q000473:pathology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010994:Pleura / Q000473:pathology / Q000601:surgery; D010995:Pleural Diseases / Q000473:pathology / Q000601:surgery*; D011030:Pneumothorax / Q000209:etiology*; D011183:Postoperative Complications / Q000209:etiology*; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult
keywords: adverse effects; biopsy; bronchoscopy; pleura; pneumothorax; risk