Effect of Rapid Rollover on Pneumothorax Rate After Percutaneous CT-Guided Lung Biopsy: A Multisite Randomized Controlled Trial Within a Single Health System.
Xiao Wu, Lynn Leng, Andrew Tong Li et al.
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In 30 seconds
This prospective, multisite randomized controlled trial evaluated rapid rollover after CT-guided lung biopsy using an anterior or lateral approach. Among 59 patients, new or enlarging pneumothorax occurred in 8 (13.6%): 7 in the control group and 1 in the intervention group. The difference was significant in both intention-to-treat and per-protocol analyses (P =0.03 and 0.009). Multivariate analysis also identified the intervention as a significant factor (P =0.0463). Postbiopsy discomfort did not differ significantly between groups.
Key findings
- New or enlarging pneumothorax occurred in 7 control patients and 1 intervention patient; overall, 8 cases represented 13.6% of participants.
- The between-group difference was significant in intention-to-treat and per-protocol analyses (P =0.03 and 0.009).
- Two patients required chest tube insertion, one in the control group and one who crossed over to control.
- Postbiopsy discomfort did not differ significantly between groups.
Why it matters
Pneumothorax is a relevant complication of percutaneous lung biopsy. In this randomized trial, rapid rollover was associated with fewer new or enlarging pneumothoraces without a detected increase in discomfort, suggesting a potentially useful procedural approach for selected anterior or lateral biopsies.
What to keep in mind
The trial included 59 patients and considered lesions most amenable to anterior or lateral approach; patients unable to reposition safely were excluded, limiting applicability to those groups.