Effect of Saline Sealing After CT-Guided Lung Biopsy on Pneumothorax and Hemoptysis

To confirm that saline sealing of the needle trace after computed tomography (CT)-guided lung biopsy reduces the incidence of pneumothorax and chest tube insertion, and to observe its effects on pulmonary hemorrhage and hemoptysis.

Patients who underwent CT-guided lung biopsy at our hospital between January 2018 and January 2024 were included in the study. Patients were divided into 2 groups according to whether the needle trace was sealed with saline after tissue sampling. Patient baseline characteristics, lung lesion factors, procedural factors, pneumothorax rates, chest tube insertion rates, pulmonary hemorrhage rates, and hemoptysis rates were recorded.

The incidence of pneumothorax was 28.9% (38/132) and 15.8% (15/95) in groups A (control) and B (with sealed traces), respectively ( P =0.002). The incidence of pneumothorax requiring chest tube insertion was significantly lower in group B than in group A (1.1% vs. 6.8%; P =0.048). The incidence of pulmonary hemorrhage was similar between the 2 groups (38.6% vs. 42.1%; P =0.599). No significant difference was observed in the hemoptysis of patients in groups A and B (6.8% vs. 10.5%; P =0.320). In the binary logistic regression analysis, significant risk factors for pneumothorax included lack of saline sealing, smaller lesion size, multiple passes through the pleura, and the lateral decubitus position. Smaller lesions and longer biopsy trace lengths were independent risk factors for hemoptysis.

Sealing the needle trace with saline significantly reduced the incidences of pneumothorax and chest tube insertion due to pneumothorax. Moreover, it did not significantly increase the incidence of pulmonary hemorrhage or hemoptysis. This technique is recommended for use in CT-guided lung biopsies.