Clinical application of radiofrequency ablation-assisted coaxial trocar biopsies for pulmonary nodules at a high risk of bleeding

J Cancer Res Ther. 2023 Aug;19(4):972-977. doi: 10.4103/jcrt.jcrt_2193_22.

Abstract

Context: The purpose of this study was to assess computed tomography (CT)-guided puncture biopsy of pulmonary nodules at a high risk of bleeding. First, a coaxial trocar technique was used to radiofrequency ablate small blood vessels in the puncture area, followed by a biopsy of the pulmonary nodule.

Aim: This study aimed to evaluate the effectiveness and safety of this procedure.

Methods: In this retrospective research, we assessed the relevant data of 45 patients who had undergone needle biopsy of pulmonary nodules at a high risk of bleeding. Twenty-five of these patients had CT-guided coaxial radiofrequency ablation (RFA)-assisted biopsy (group A). The remaining 20 had undergone conventional CT-guided needle biopsy (group B). We equated the technical success rate and the incidence of complications such as bleeding, pneumothorax, and pain in the two groups of needle biopsies.

Results: Both groups had a 100% success rate with puncture biopsy. The incidences of pneumothorax in groups A and B were 10% (2/20) and 24% (6/25), respectively; this difference is not significant (P > 0.050). The rates of bleeding in groups A and B were 10% (2/20) and 44% (11/25), respectively, and the rates of pain were 30% (6/20) and 60% (15/25), both of which were statistically significant (P = 0.030; P = 0.045, respectively).

Conclusions: CT-guided coaxial trocar technique for RFA-assisted biopsy of pulmonary nodules at a high risk of bleeding is effective and safe and can significantly reduce the risk of biopsy-induced pulmonary hemorrhage.

Keywords: Coaxial trocar; hemorrhage; lung nodules; needle biopsy; radiofrequency ablation.

MeSH terms

  • Hemorrhage / etiology
  • Hemorrhage / prevention & control
  • Humans
  • Image-Guided Biopsy / adverse effects
  • Multiple Pulmonary Nodules* / diagnosis
  • Multiple Pulmonary Nodules* / surgery
  • Pain
  • Pneumothorax*
  • Radiofrequency Ablation* / adverse effects
  • Retrospective Studies