The surgeon’s needle and the assurance of diagnosis - New players in CT-guided tru-cut biopsy

Sep 29, 2026

Uploaded by Finn

Retrospective evidence evaluates percutaneous transthoracic lung tru-cut biopsy under computed tomography guidance performed by thoracic surgeons. From January 1, 2015 to January 31, 2024, 793 patients (632 males, 160 females; mean age 65±12 years) underwent CT-guided sampling, with 973 biopsy procedures analyzed using Hospital Information System and PACS-accessible records. First-attempt definitive diagnosis occurred in 78.6%, with 21.4% requiring repeat biopsies. Complications included pneumothorax (16.1%), and lower rates of bleeding and hemothorax; risk increased with greater parenchymal penetration and differed by lobe.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages10

Reading Time25 min

AccessFree to download

ABSTRACT

Background

Methods

Results

Conclusion

Keywords

Turkish Journal of Thoracic and Cardiovascular Surgery 2025;33(4):528-537 Orıgınal Artıcle / Özgün Makale The surgeon’s needle and the assurance of diagnosis: New players in CT-guided tru-cut biopsy Cerrahın iğnesi, tanının güvencesi: BT eşliğinde tru-cut biyopsinin yeni oyuncuları Mehmet Akif Tezcan􀀬, İbrahim Ethem Özsoy􀀬, Bayram Metin􀀬, Oğuzhan Turan􀀬, Mehmet Akif Ekici􀀬 Department of Thoracic Surgery, University of Health Sciences, Kayseri City Training and Research Hospital, Kayseri, Türkiye ABSTRACT Background: This study aims to encourage the use of percutaneous transthoracic biopsies by thoracic surgeons as a diagnostic method. Methods: This retrospective study was conducted between January 1, 2015, and January 31, 2024, with 793 patients (632 males, 160 females; mean age: 65±12 years; range, 11 to 93 years) who underwent lung tru-cut biopsy under computed tomography guidance. Patients whose radiologic and pathology records were accessible via the Hospital Information System and the Picture Archiving and Communication System were included. Results: A total of 973 tru-cut biopsy procedures were performed. There was no statistically significant difference in age distribution between sexes (p=0.15) . Most biopsies were performed on the upper lobes, predominantly the right upper lobe (33.2%) . The supine position was the most commonly used during the procedure (49.4%) . The mean lesion diameter and distance from the chest wall were 49±17 mm and 51±16 mm, respectively. A definitive diagnosis was obtained on the first attempt in 78.6% of patients, while repeat biopsies were required in 21.4% . Primary lung malignancy was diagnosed in 63% of cases. Postprocedural complications included pneumothorax in 16.1%, intraparenchymal hemorrhage in 0.1%, hemoptysis in 0.1%, and hemothorax in 0.1% of patients. Complications were most frequently observed following biopsies of the left lower lobe (32.4%) . Lesions located in the upper lobes were significantly more likely to be malignant (p=0.01). A significant increase in complication rates was observed with greater parenchymal tissue penetration during the procedure (p=0.001) . Conclusion: Computed tomography-guided percutaneous lung biopsies can be performed more safely by thoracic surgeons due to their procedural experience. Additionally, in the event of complications, thoracic surgeons are more capable of providing prompt and effective intervention, thereby enhancing patient safety. Thoracic surgeons should be actively involved in all diagnostic stages of pulmonary or mediastinal nodules or masses, including procedures such as tru-cut lung biopsy and endobronchial ultrasonography. Keywords: Lung biopsy, lung cancer, pulmonary nodule, thoracic surgery, tru-cut biopsy. ÖZ Amaç: Bu çalışmada tanıda kullanılan yöntemlerden biri olan perkütan transtorasik biyopsinin göğüs cerrahları tarafındanuygulanmasını teşvik etmek amaçlandı . Çalışma planı: Bu retrospektif çalışma 01.01.2015-31.01.2024 tarihleri arasında bilgisayarlı tomografi eşliğinde akciğer tru-cut biyopsi uygulanan 793 hasta (632 erkek, 160 kadın; ort . yaş: 65±12 yıl; dağılım, 11-93 yıl) ile yürütüldü . Hastane Bilgi Sistemi ve Görüntü Saklama ve İletişim Sistemlerikullanılarak radyoloji ve patoloji sonuçlarına ulaşılan hastalar çalışmaya dahil edildi. Bulgular: Toplamda 973 tru-cut biyopsi işlemi yapıldı . Her iki cinsiyette yaş dağılımı açısından anlamlı bir farklılık yoktu (p=0.15) . Biyopsi en çok üst loblara, ağırlıklı olarak da sağüst loba yapıldı (%33 . 2) . İşlem sırasında en sık supin pozisyon kullanıldı (%49.4) . Lezyonların ortalama çapı ve göğüs duvarınauzaklığı sırasıyla 49±17 ve 51±16 mm idi. Hastaların %78.6’sınailk girişimde kesin tanı konulurken,%21.4’ünde tekrarlayan biyopsiler gerekti. Hastaların %63’üne primer akciğer malignitesitanısı kondu . İşlem sonrası komplikasyonlar hastaların %16.1’inde pnömotoraks,%0.1’inde intraparankimal hemoraji,%0.1’inde hemoptizi ve %0.1’inde hemotor

FAQs

What was the study designed to encourage regarding diagnosis?

The study aimed to encourage thoracic surgeons to use percutaneous transthoracic biopsies as a diagnostic method.

How many patients and biopsy procedures were included?

The study included 793 patients who underwent lung tru-cut biopsy, with a total of 973 biopsy procedures performed.

What were the main post-procedure complications and how did risk change?

Pneumothorax was the most common complication (16.1%), with lower rates of intraparenchymal hemorrhage, hemoptysis, and hemothorax. Complication rates increased significantly with greater parenchymal tissue penetration during the procedure.

Sep 29, 2026

Uploaded by Finn