Hiraki Takao, Tajiri Nobuhisa, Mimura Hidefumi, Yasui Kotaro, Gobara Hideo, Mukai Takashi, Hase Soichiro, Fujiwara Hiroyasu, Iguchi Toshihiro, Sano Yoshifumi, Shimizu Nobuyoshi, Kanazawa Susumu
Departments of Radiology and Cancer and Thoracic Surgery, Okayama University Medical School, 2-5-1 Shikatacho, Okayama 700-8558, Japan.
Radiology. 2006 Oct;241(1):275-83. doi: 10.1148/radiol.2411051087. Epub 2006 Aug 14.
To retrospectively evaluate the incidence of and risk factors for pneumothorax, pleural effusion, and chest tube placement for pneumothorax after radiofrequency (RF) ablation of lung tumors.
Institutional review board approval was obtained, with waiver of informed consent. This retrospective study comprised 224 ablation sessions for 392 tumors in 142 patients (92 men, 50 women; mean age, 64.0 years). Multiple variables were analyzed by using the Student t test or the Mann-Whitney U test for numerical values and by using the chi(2) test or the Fisher exact test for categorical values in order to assess risk factors for pneumothorax, pleural effusion, and chest tube placement for pneumothorax.
The incidence of pneumothorax, pleural effusion, and chest tube placement for pneumothorax was 52% (117 of 224 sessions), 19% (42 of 224 sessions), and 21% (24 of 117 sessions), respectively. For pneumothorax, risk factors included male sex (P = .030), no history of pulmonary surgery (P < .001), a greater number of tumors ablated (P < .001), involvement of the middle or lower lobe (P = .008), and increased length of the aerated lung traversed by the electrode (P = .014). For pleural effusion, risk factors included the use of a cluster electrode (P = .008), decreased distance to the nearest pleura (P = .040), and decreased length of the aerated lung traversed by the electrode (P = .019). For chest tube placement for pneumothorax, risk factors included no history of pulmonary surgery (P = .002), the use of a cluster electrode (P < .001), and involvement of the upper lobe (P < .001).
Pneumothorax and pleural effusion can occur after RF ablation in patients with lung tumors, and chest tube placement for pneumothorax is sometimes required.
回顾性评估肺肿瘤射频（RF）消融术后气胸、胸腔积液及气胸胸腔闭式引流的发生率及危险因素。
获得机构审查委员会批准，豁免知情同意。这项回顾性研究包括对142例患者（92例男性，50例女性；平均年龄64.0岁）的392个肿瘤进行的224次消融治疗。对多个变量进行分析，数值变量采用Student t检验或Mann-Whitney U检验，分类变量采用卡方检验或Fisher精确检验，以评估气胸、胸腔积液及气胸胸腔闭式引流的危险因素。
气胸、胸腔积液及气胸胸腔闭式引流的发生率分别为52%（224次治疗中的117次）、19%（224次治疗中的42次）和21%（117次气胸治疗中的24次）。对于气胸，危险因素包括男性（P = 0.030）、无肺手术史（P < 0.001）、消融肿瘤数量较多（P < 0.001）、累及中叶或下叶（P = 0.008）以及电极穿过的充气肺长度增加（P = 0.014）。对于胸腔积液，危险因素包括使用集束电极（P = 0.008）、与最近胸膜的距离减小（P = 0.040）以及电极穿过的充气肺长度减小（P = 0.019）。对于气胸胸腔闭式引流，危险因素包括无肺手术史（P = 0.002）、使用集束电极（P < 0.001）和累及上叶（P < 0.001）。
肺肿瘤患者RF消融术后可发生气胸和胸腔积液，有时需要进行气胸胸腔闭式引流。
