2024 Asia Conference on Lung Cancer (ACLC) - Poster & ePosters-PP02.62

PP02.62 - Jianxin Xu

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This study examines the risk factors associated with pneumothorax occurrences during the localization of pulmonary nodules (PNs) using computed tomography (CT)-guided injection of autologous blood. This method is recognized for being simple, effective, economical, and intuitive, allowing preoperative localization of PNs. The main aim is identifying what risks contribute to pneumothorax when using this technique.<br /><br />The study defines successful localization as the appearance of a blood stain on the visceral pleura during thoracoscopy, with or without additional guidance from pinholes, and successful radiographic excision of nodules in specimens. In the study, PN localization was achieved successfully in 96.7% of cases, and all nodules were surgically removed using video-assisted thoracoscopic surgery (VATS), avoiding conversion to thoracotomy.<br /><br />Complications noted were minor pneumothorax in 17.3% of cases and mild pulmonary hemorrhage in 2.0% of cases. Notably, risk analysis uncovered that factors such as the depth of needle-to-lung tissue contact and smaller nodule size (with P-values of 0.042 and 0.014, respectively) are significant independent risk factors for pneumothorax during the localization procedure.<br /><br />A predictive nomogram model was established to assess the probability of developing pneumothorax, showing an area under the curve (AUC) of 0.713, indicating moderate predictive accuracy. This model serves as a tool for assessing potential risks in patients planned for PN localization using autologous blood injection.<br /><br />The overall conclusion is that smaller nodules and deeper needle contact with lung tissue contribute to pneumothorax risk, and the developed predictive model is valuable in forewarning against complications during the procedure.

Keywords

pneumothorax

pulmonary nodules

CT-guided injection

autologous blood

risk factors

video-assisted thoracoscopic surgery

predictive nomogram model

needle-to-lung contact

nodule size

thoracoscopy