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[CT-guided fine-needle thoracic aspiration puncture. Its cost effectiveness and complications]
F García Río1, S Díaz Lobato, M Atienza
1Servicio de Neumología, Hospital La Paz, Facultad de Medicina, Universidad Autónoma, Madrid.
Objective:
To study the profitability and complications of the puncture aspiration with thoracic thin-needle (PATTN).
Methodology:
The results of 160 PATTN, performed under TC control in 131 men and 29 women, average age 61.24 +/- 15.17 years were analyzed. The diagnosis obtained by PATTN was compared with the definitive diagnosis made with biopsy (bronchial, thoracotomy, or mediastinoscopy), the evolution or response to treatment, or at autopsy. Factor related to greater diagnostic reliability and risk of pneumothorax were analyzed.
Results:
For the diagnosis of non-tumoral pathology, the technique achieved a sensitivity (S) of 90 percent, specificity (E) of 96.06 percent, and reliability (F) of 91.71 percent, while in malignant processes, S 72.4 percent, E 100 percent and F 88.52 percent, with a histological correlation of 72.72 percent in the first case and 68.80 percent in the second. The localization in superior lobes, radiological pattern of multiple or cavitied nodules, and size > 2 cm were identified as factors which significantly increased reliability. Pneumothorax was produced in 24 cases (15 percent) and was more common in patients diagnosed of COPD, with a lesion < 2.1 cm, and not attached to the pleura.
Conclusions:
The PATTN offers considerable profitability for the diagnosis of thoracic lesions of any localization and nature, at low costs and with few serious complications.