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Vol. 26. Issue 5.
Pages 186-191 (June - July 1990)
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Vol. 26. Issue 5.
Pages 186-191 (June - July 1990)
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Complicaciones y riesgo de la punción aspirativa transtorácica. Estudio en 873 pacientes y revisión de la literatura
Complications and risks of transthoracic aspirative punction. Study in 873 patiens and literature review
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M.A. de Gregorio Ariza, J. Torrez Nuez, E.R. Alfonso Aguirán, J.L. Villavieja Atance
Departamento de Radiología, Hospital Clínico Universitario. Zaragoza
F. Duce Gracia*, E. Bustamante Arias**
* Servicio de Neumología. Hospital Clínico Universitario. Zaragoza
** Sección de Cirugía Torácica. Hospital Clínico Universitario. Zaragoza
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La punción aspirativa transtorácica (PAT) constituye un procedimiento efectivo y razonablemente seguro en el diagnóstico de la patología pulmonar.

Hemos estudiado las complicaciones en 873 pacientes a los que se realizó PAT. De ellos, 133 (15,2%) presentaron neumotórax de los que tan sólo el 13,5% fueron de carácter severo. Las lesiones de menor tamaño (1-2 cm) presentaron el mayor índice de neumotórax (29,6%), así como las lesiones periféricas (17,9%) frente a las centrales (11,7%).

El número de pases sobre la lesión fue decisivo en nuestra serie para la producción de neumotórax (8,2% con 1 pase, 17,7% con 2 pases y 21,9% con 3 pases) así como los antecedentes de broncopatía crónica (EPOC) (78,8%). Otras complicaciones fueron la hemoptisis (1,3%), hemorragia parenquimatosa (0,7%/), dolor (4,9%), vagotonía (0,9%), enfisema intersticial (0,1%) e hidroneumotórax (0,1%).

En nuestra serie no hubo ninguna complicación fatal, ni implante tumoral en el trayecto de punción. Se comparan nuestros resultados con los revisados en la literatura médica.

Transthoracic aspiration biopsy (TAB) constitutes a reasonable safe and effective procedure in the pulmonary pathology diagnosis. Complications in 873 patients with TAB have been studied. Pneumothorax was presented in 133 (15,2%) of them, but only 13,5% were important.

The smallest size lesions (1-2 cm) were the most frecuent of pneumothorax (29,6%) as well as the peripherycal lesions (17,9%) opposite central lesions (11,7%).

In our serie the number of passes over the lessions and POAC (78,8%) antecedents was decisive in pneumothorax apparition (8,2% with one pass, 17,7% with two passes, and 21,9% with three passes).

Other complications were: hemoptysis (1,3%), parenchymal hemorrhage (0,7%), pain (4,9%), vagotonic syndrome (0,9%), interstitial emphysema (0,1%) and hydropneumothorax (0,1%).

Any fatal complication or tumoral spreading in the biopsy path was reported in our serie.

Our results are compared with those of medical literature.

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Bibliografía
[1.]
E.N. Sargent, A.F. Turner, J. Gordonson, C.P. Schwinn, D. Pashky.
Percutaneous pulmonary needle biopsy. Report of 350 patients.
Am J Roentgenol, 122 (1974), pp. 758-768
[2.]
A.F. Lallí, L.J. McCormack, M. Zelch, N.E. Reich, D. Belovich.
Aspiration biopsies of chest lesions.
Radiology, 127 (1978), pp. 35-40
[3.]
N.F. Khouri, F.P. Stitik, Y.S. Erozan, et al.
Transthoracic needle aspiration biopsy of benign and malignant lung lesions.
AJR, 144 (1985), pp. 281-288
[4.]
L.M. Perlmutt, W.W. Johnston, N.R. Dunnick.
Percutaneous transthoracic needle aspiration: A review.
AJR, 152 (1989), pp. 451-455
[5.]
M.A. De Gregorio, F. Conget, R. Marco, A. Mainar, J. Azúa, M. Roca.
La punción aspirativa transtorácica (PAT) como método de diagnóstico en las enfermedades pulmonares.
Arch Bronconeumol, 21 (1985), pp. 150-154
[6.]
W.N. Sinner.
Complications of percutaneous transthoracic needle aspiration biopsy.
Acta Radiol, 17 (1976), pp. 813-828
[7.]
J.H. Stanley, G.D. Fish, J.G. Andriole, et al.
Lung lesions: cytologic diagnosis by fine-needle biopsy.
Radiology, 162 (1987), pp. 389-391
[8.]
V.W. Lauby, W.E. Burnett, R.R. Tyson, G.P. Rosemond.
Value and risk of biopsy of pulmonary lesions by needle aspiration. Twentyone years’ experience.
J Thorac Cardiovasc Surg, 49 (1965), pp. 159
[9.]
W.G. Smith.
Needle biopsy of lung.
Lancet, 2 (1964), pp. 318
[10.]
J.S. Adamson, J.H. Bates.
Percutaneous needle biopsy of the lung.
Arch Intern Med, 119 (1967), pp. 164-169
[11.]
J.E. Meyer, J.T. Ferruci, M.L. Janower.
Fatal complications of percutaneous lung biopsy. Review of the literature and report of a case.
Radiology, 96 (1970), pp. 47-48
[12.]
C.R. Youmans, W.J. deGroot, R. Marshall, L.B. Moretin, J.R. Derric.
Needle biopsy of the lung in diffuse parenchymal disease: an analysis of 151 cases.
Am J Surg, 120 (1970), pp. 637-643
[13.]
R.L. McCartney.
Hemorrage following percutaneous lung biopsy.
Radiology, 112 (1974), pp. 305-307
[14.]
R. Norenberg, C.P. Claxton, T. Takaro.
Percutaneous needle biopsy of the lung: report of two fatal complications.
Chest, 66 (1974), pp. 216-218
[15.]
J.G. Pearce, N.L. Patt.
Fatal pulmonary hemorrage after percutaneous aspiration lung biopsy.
Am Rev Respir Dis, 110 (1974), pp. 346-349
[16.]
A.J. Roncoroni.
Fatal complication in percutaneous needle biopsy of the lung.
Chest, 68 (1975), pp. 388
[17.]
L.B. Milner, K. Ryan, J. Gullo.
Fatal intrathoracic hemorrage after percutaneous aspiration lung biopsy.
AJR, 132 (1979), pp. 280-281
[18.]
C.R. Woolf.
Aplications of aspiration lung biopsy with a review of the literature.
Dis Chest, 25 (1954), pp. 286-301
[19.]
J.B. Jameson.
Aspiration biopsy of localized intrathoracic lesions.
Austral Radiol, 14 (1970), pp. 40-45
[20.]
J.L. Westcott.
Air embolism complicating percutaneous needle biopsy of the lung.
Chest, 63 (1973), pp. 108-110
[21.]
D.R. Aberle, G. Gamsu, J.A. Golden.
Fatal systemic arterial air embolism following lung needle aspiration.
Radiology, 165 (1987), pp. 351-353
[22.]
Cianci, J.P. Posin, R.R. Shimshak, R.R. Simshak, J. Singzon.
Air embolism complicating percutaneous thin needle biopsy of lung.
Chest, 92 (1987), pp. 749-751
[23.]
T.L. Tolly, J.E. Feldmeler, D. Czarnecki.
Air embolism complicating percutaneous lung biopsy.
[24.]
F.R. Dutra, C.L. Geraci.
Needle biopsy of lung.
JAMA, 155 (1954), pp. 21-24
[25.]
H. Wolinsky, M.W. Lischner.
Needle track implantation of tumor after percutaneous lung biopsy.
Ann Intern Med, 71 (1969), pp. 359-362
[26.]
R.L. Berger, E.L. Dargan, B.L. Huang.
Dissemination of cancer cells by needle biopsy of the lung.
J Thorac Cardiovasc Surg, 63 (1972), pp. 430-432
[27.]
B. Naylor.
Dissemination of cancer cells after needle biopsy of lung.
J Thorac Cardiovasc Surg, 64 (1972), pp. 324
[28.]
N.L. Müller, C.J. Bergin, R.R. Miller, D.N. Ostrow.
Seeding of malignant cells into the needle tract after lung and pleural biopsy.
J Can Assoc Radiol, 37 (1986), pp. 192-194
[29.]
E.N. Sargent, A.F. Turner.
Emergency treatment of pneumothorax: a simple catheter technique for use in the radiology department.
AJR, 109 (1970), pp. 531-535
[30.]
J.L. Westcott.
Direct pecutaneous needle aspiration of localized pulmonary lesions: results in 422 patients.
[31.]
G.M. Stevens, R.J. Jackman.
Outpatient needle biopsy of the lung: its safety and utility.
Radiology, 151 (1984), pp. 301-304
[32.]
L.M. Perlmutt, S.D. Braun, G.E. Newman, et al.
Transthoracic needle aspiration: use of a small chest tube to treat pneumothorax.
AJR, 148 (1987), pp. 849-851
[33.]
G. Casola, E. van Sonnenberg, A. Keightley, M. Ho, C. Withers, A.S. Lee.
Pneumothorax: Radiologic treatment with small catheters.
[34.]
I.S. Johnsrude, J.F. Silverman, M.D. Weaver, W. McConnell.
Rapid cytology to deerease pneumothorax incidence after percutaneous biopsy.
AJR, 144 (1985), pp. 793-794
[35.]
D.J. Conces, S.A. Clark, R.D. Tarver, G.R. Schwenck.
Transthoracic aspiration needle biopsy: value in the diagnosis of pulmonary infections.
AJR, 152 (1989), pp. 31-34
[36.]
A.J.S. House, K.R. Thomson.
Evaluation of a new transthoracic needle for biopsy of benign and malignant lung lesions.
Am J Roentgenol, 129 (1977), pp. 215-220
[37.]
B.J. Nahman, M.E. van Aman, W.E. McLemore, R.V. O’Toole.
Use of the Rotex needle in percutaneous biopsy of pulmonary malignancy.
AJR, 145 (1985), pp. 97-99
[38.]
R.H. Poe, M.C. Kallay, C.M. Wicks, C.L. Odoroff.
Predicting risk of pneumothorax in needle biopsy of the lung.
Chest, 85 (1984), pp. 232-235
[39.]
G.D. Fish, J.H. Stanley, K.S. Miller, S.J. Schabel, S.E. Sutherland.
Postbiopsy pneumothorax: estimating the risk by chest radiography and pulmonary function tests.
AJR, 150 (1988), pp. 71-74
[40.]
K.S. Miller, G.B. Fish, J.H. Stanley, S.J. Schabel.
Prediction of pneumothorax rate in percutaneous needle aspiration of the lung.
Chest, 93 (1988), pp. 742-745
[41.]
A.J. Williams, S. Santiago, S. Lehrman, R. Popper.
Transcutaneous needle aspiration of solitary pulmonary masses: How many passes?.
Am Rev Respir Dis, 136 (1987), pp. 452-454
[42.]
D.A. Miller, C.H. Carrasco, R.L. Katz, F.M. Cramer, S. Wallace, C. Charnsangavej.
Fine needle aspiration biopsy: the role of immediate cytologic assessment.
AJR, 147 (1986), pp. 155-158
[43.]
M. Jereb.
The usefulness of needle biopsy in chest lesions of different sizes and locations.
[44.]
R.D. Johnson, R.P. Gobien, J.F. Valicenti.
Current status of radiologically directed pulmonary thin needle aspiration biopsy. An analysis of 200 consecutive biopsies and review of the literature.
Ann Clin Lab Sci, 13 (1983), pp. 225-239
[45.]
R.H. Poe, M.C. Kallay.
Transthoracic needle biopsy of lung in nonhospitalized patients.
Chest, 92 (1987), pp. 676-678
[46.]
T.H. Berquist, P.B. Bailey, D.A. Cortese, W.E. Miller.
Transthoracic needle biopsy. Accuracy and complications in relation to location and type of lesion.
Mayo Clin Proc, 55 (1980), pp. 475-481
[47.]
R.A. Krumholz, F. Mandredi, J.G. Web, D. Rosenbaum.
Needle biopsy of the lung. Report on its use in 112 patients and review of the literature.
Ann Intern Med, 65 (1966), pp. 293-307
[48.]
D.C. Zavala, G.N. Bedell.
Percutaneous lung biopsy with a cutting needle. An analysis of 40 cases and comparison with other biopsy techniques.
Am Rev Resp Dis, 106 (1972), pp. 186-193
[49.]
P.G. Herman, S.J. Hessel.
The diagnostic accuracy and complications of closed lung biopsies.
Radiology, 125 (1977), pp. 11-14
[50.]
I. Pueyo, F. Fernández, A. Guzmán, et al.
Punción aspiración pulmonar en carcinoma broncogénico. Estudio en 216 pacientes.
Radiología, 23 (1981), pp. 12-128
[51.]
E. Van Sonnenberg, G. Casola, M. Ho, et al.
Difficult thoracic lesions: CT-guided biopsy experience in 150 cases.
Radiology, 167 (1988), pp. 457-461
[52.]
D.J. Conces, G.R. Schwenck, P.R. Doering, M.D. Glant.
Thoracic needle biopsy. Improved results utilizing a team approach.
Chest, 91 (1987), pp. 813-816
[53.]
J. Zornoza, J. Snow, J.M. Lukeman, H.I. Libshitz.
Aspiration biopsy of discrete pulmonary lesions using a new thin needle.
Radiology, 123 (1977), pp. 519-520
[54.]
J. Cáceres.
Técnica de radiología intervencionista y su aplicación.
Med Clin (Barc), 81 (1983), pp. 634-639
[55.]
T.L. Amtson, W.R. Boyd.
Percutaneous biopsy using a safe, effective needle.
Radiology, 127 (1978), pp. 265
Copyright © 1990. Sociedad Española de Neumología y Cirugía Torácica
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