Koaksiyel teknik ile yapılan transtorasik akciğer biyopsilerinde otolog kan yaması yönteminin etkinliğinin değerlendirilmesi
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Dosyalar
Tarih
2021
Yazarlar
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Yayıncı
Trakya Üniversitesi Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Bu çalışmada koaksiyel teknik ile yapılan perkütan transtorasik akciğer biyopsilerinde otolog kan yaması yönteminin etkinliğini değerlendirmeyi amaçladık. Retrospektif olarak gerçekleştirilen çalışmamıza, etik kurul onamı alınmış ve hastanemizde Girişimsel Radyoloji biriminde perkütan koaksiyel teknik ile transtorasik akciğer biyopsisi yapılan 240 hasta çalışmaya dahil edilmiştir. Çalışmaya dahil edilen hastaların sistemimizdeki biyopsi planlama ve takip görüntüleri üzerinden lezyon ve akciğer parankim özellikleri, pnömotoraks ve diğer komplikasyonları değerlendirilmiştir. İstatistiksel analiz sonucunda otolog kan yaması yönteminin koaksiyel teknik ile yapılan transtorasik akciğer biyopsilerinde pnömotoraks oranlarında anlamlı ölçüde düşüş sağladığı bulunmuştur (p<0.001). Plevral tabanlı olmayan lezyonlarda yapılan biyopsilerde pnömotoraks sıklığı daha yüksek bulunmuş olup plevral uzaklık arttıkça pnömotoraks riskinin arttığı sonucuna ulaşılmıştır. Bunun sonucunda plevral tabanlı olan ve olmayan lezyonlarda yapılan biyopsilerde ayrı ayrı değerlendirilen otolog kan yaması yöntemi etkinliğinin plevral tabanlı olmayan lezyonlarda pnömotoraks oranını anlamlı oranda azalttığı bulunmuştur (p=0,003). Pnömotoraks artışı açısından kan yaması yapılan grup ile yapılmayan grubu karşılaştırdığımızda pnömotoraks artışı saptanan olgu oranı kan yaması yapılan grupta anlamlı olarak daha az olduğu sonucuna ulaşılmıştır (p<0.001). Koaksiyel teknik ile yapılan transtorasik akciğer biyopsilerinin tanısal doğruluğu arttırdığı bilinmektedir. Ayrıca tek girişle birden fazla doku parçası elde olunarak histopatolojik çalışmanın yanı sıra son dönemde önemi giderek artan moleküler ve genetik analizler için daha fazla doku parçası örneklenebilmektedir. Sonuç olarak otolog kan yaması yöntemi kullanılarak koaksiyel teknik ile bilgisayarlı tomografi eşliğinde yapılan perkütan transtorasik akciğer biyopsilerinde daha fazla doku materyali elde edilebilirken aynı zamanda en sık komplikasyon olan pnömotoraks riskinin azaltılması da sağlanacağından bu yöntemin kullanımının artacağını düşünmekteyiz.
In this study, we aimed to evaluate the effectiveness of the autologous blood patch method in percutaneous transthoracic lung biopsies performed with the coaxial technique. Ethics committee approval was obtained in our retrospective study, and 240 patients who involved transthoracic lung biopsy with percutaneous coaxial technique in the Interventional Radiology unit of our hospital were included in the study. The lesion and lung parenchyma features, pneumothorax and other complications of the patients included in the study were evaluated through biopsy planning and follow-up images in our system. As a result of statistical analysis, it was found that the autologous blood patch method provided a significant decrease in pneumothorax rates in transthoracic lung biopsies performed with the coaxial technique (p<0.001). The frequency of pneumothorax was found to be higher in biopsies performed in non-pleural-based lesions, and it was concluded that the risk of pneumothorax increased as the pleural distance increased. As a result, it was found that the efficacy of the autologous blood patch method, which was evaluated separately in biopsies performed in lesions with and without pleural base, significantly reduced the rate of pneumothorax in lesions without pleural bases (p=0.003). In terms of increase in pneumothorax, when we compared the group in which the blood patch was applied and the group that did not, it was concluded that the rate of cases with increased pneumothorax was significantly lower in the blood patched group (p<0.001). It is known that transthoracic lung biopsies performed with the coaxial technique increase the diagnostic accuracy. In addition, more tissue pieces can be sampled for histopathological studies, as well as for molecular and genetic analysis, which has become increasingly important recently, by obtaining more than one tissue piece with a single entry. As a result, we think that the use of this method will increase, as more tissue material can be obtained in percutaneous transthoracic lung biopsies performed with coaxial technique and computed tomography using the autologous blood patch method, while reducing the risk of pneumothorax, the most common complication, at the same time.
In this study, we aimed to evaluate the effectiveness of the autologous blood patch method in percutaneous transthoracic lung biopsies performed with the coaxial technique. Ethics committee approval was obtained in our retrospective study, and 240 patients who involved transthoracic lung biopsy with percutaneous coaxial technique in the Interventional Radiology unit of our hospital were included in the study. The lesion and lung parenchyma features, pneumothorax and other complications of the patients included in the study were evaluated through biopsy planning and follow-up images in our system. As a result of statistical analysis, it was found that the autologous blood patch method provided a significant decrease in pneumothorax rates in transthoracic lung biopsies performed with the coaxial technique (p<0.001). The frequency of pneumothorax was found to be higher in biopsies performed in non-pleural-based lesions, and it was concluded that the risk of pneumothorax increased as the pleural distance increased. As a result, it was found that the efficacy of the autologous blood patch method, which was evaluated separately in biopsies performed in lesions with and without pleural base, significantly reduced the rate of pneumothorax in lesions without pleural bases (p=0.003). In terms of increase in pneumothorax, when we compared the group in which the blood patch was applied and the group that did not, it was concluded that the rate of cases with increased pneumothorax was significantly lower in the blood patched group (p<0.001). It is known that transthoracic lung biopsies performed with the coaxial technique increase the diagnostic accuracy. In addition, more tissue pieces can be sampled for histopathological studies, as well as for molecular and genetic analysis, which has become increasingly important recently, by obtaining more than one tissue piece with a single entry. As a result, we think that the use of this method will increase, as more tissue material can be obtained in percutaneous transthoracic lung biopsies performed with coaxial technique and computed tomography using the autologous blood patch method, while reducing the risk of pneumothorax, the most common complication, at the same time.
Açıklama
Anahtar Kelimeler
Akciğer kanseri, Perkütan transtorasik akciğer biyopsi, Bilgisayarlı tomografi, Koaksiyel teknik, Otolog kan yaması yöntemi, Pnömotoraks, Lung cancer, Percutaneous transthoracic lung biopsy, Computed tomography, Coaxial technique, Autologous blood patch method, Pneumothorax
