Risk factors of pneumothorax after endobronchial ultrasound-guided transbronchial biopsy for peripheral lung lesions

PLoS One. 2012;7(11):e49125. doi: 10.1371/journal.pone.0049125. Epub 2012 Nov 7.


Background: The risk of endobronchial ultrasound-guided transbronchial biopsy-related pneumothorax is a major concern and warrants further studies. The aim of our study was to estimate the risk of pneumothorax after this procedure and identify its risk factors.

Methods: From 2007 to 2011, 399 patients who underwent endobronchial ultrasound-guided transbronchial biopsy for peripheral lung lesions were included in this study. The variables analyzed included patient factors, lesion factors and procedure factors. Multivariate logistic regression analysis was used to identify independent risk factors for pneumothorax.

Results: The incidence of pneumothorax was 3.3% (13/399). Chest tube placement was required for 31% (4/13) of pneumothoraces. Independent risk factors for pneumothorax included pulmonary emphysema (OR, 55.09; 95% CI, 9.37-324.03; p<0.001) and probe position adjacent to the lesion (OR, 17.01; 95% CI, 2.85-101.64; p = 0.002). The number of biopsy specimens, age, sex, history of prior lung surgery and lesion size, location and character did not influence the risk of pneumothorax in our analyses.

Conclusions: The risk of pneumothorax after endobronchial ultrasound-guided transbronchial biopsy is low. To further reduce the risk of pneumothorax, every effort should be made to advance the endobronchial ultrasound probe into the bronchus where it is imaged within the target lesion before embarking on transbronchial biopsy.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Biopsy / adverse effects*
  • Bronchi* / diagnostic imaging
  • Bronchi* / pathology
  • Female
  • Humans
  • Lung* / diagnostic imaging
  • Lung* / physiopathology
  • Male
  • Middle Aged
  • Pneumothorax* / etiology
  • Pneumothorax* / physiopathology
  • Pulmonary Emphysema / complications
  • Pulmonary Emphysema / diagnosis
  • Pulmonary Emphysema / physiopathology
  • Risk Factors
  • Tomography, X-Ray Computed
  • Ultrasonography

Grants and funding

This study was sponsored by the Taiwan National Science Council (NSC 101-2321-B-002-027). The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.