Thesis (Ph.D.) - Cairo University - National Cancer Institute - Department of Oncoology (Radiotion)

(CT)-guided lung biopsy is a safe effective procedurefor tissue sampling.Pneumothorax and pulmonary hemorrhage are the commonestcomplications. Ways of preventing these complications remain of great interest.Gel foam sponge is an inexpensive material that can be prepared into an injectable slurry, hypothesized to decrease the riskof post procedural complications if injected in the biopsy tract. We aim in our study to evaluate the efficiency of post transthoracic biopsy tract embolization by gel foam slurry to reduce post biopsy pneumothorax, hemorrhage, chest tube insertion and thus hospitalization. We prospectively compared 70 CT guided biopsiesperformed with tract embolization to 68 controls. After the biopsy, patients were kept under 4-6 hours observation.Pre- procedural, procedural risk factors were recorded and. The study was performed starting January 2018 on the course of 18 months. Logistic step wise regression analysis for the risk factors of pneumothorax, hemothorax, chest tube placement and hospital admission. Results: There was no significant difference comparing both groups regarding risk factor representation. There was no significant reduction in the rates of pneumothorax and hemorrhage, however there was a significant decrease of chest tube insertion(19.1% vs. 7.1%, p=0.037), hemothorax(13.2 vs. 2.9%, p= 0.024 ) and hospital admission rates (19.1% vs. 4.3%, p= 0.007).The only common factor increasing the odds of complications was needle pleural angle more than 70{u25E6}, where pneumothorax increased by2.859 times (p=0.005), chest tube increased by 3.1 times (p=0.034). None of the embolized cases or controls, required further surgical intervention and no mortalities were recorded

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