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Original Research: MALIGNANT DISEASE |

Delayed and Recurrent Pneumothorax After Radiofrequency Ablation of Lung Tumors

Rika Yoshimatsu, MD; Takuji Yamagami, MD, PhD; Koshi Terayama, MD, PhD; Tomohiro Matsumoto, MD; Hiroshi Miura, MD; Tsunehiko Nishimura, MD, PhD
Author and Funding Information

*From the Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.

Correspondence to: Rika Yoshimatsu, MD, Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-chyo, Kawaramachi-Hirokoji, Kamigyo, Kyoto, 602-8566, Japan; e-mail rika442@koto.kpu-m.ac.jp


The authors have reported to the ACCP that no significant conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestjournal.org/misc/reprints.shtml).


Chest. 2009;135(4):1002-1009. doi:10.1378/chest.08-1499
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Background:  In daily clinical work, we often face delayed or recurrent pneumothorax after radiofrequency (RF) ablation for lung tumors, but a large study on this theme has not been done. Thus, we examined the rate of delayed or recurrent pneumothorax after RF ablation for lung tumors and the risk factors associated with its occurrence.

Materials and methods:  This retrospective study was based on 194 consecutive sessions of percutaneous RF ablation of 220 lung tumors in 68 patients performed under CT fluoroscopic guidance at a single institution. Numerous variables were analyzed to the assess risk factors for delayed or recurrent pneumothorax.

Results:  Pneumothorax after RF ablation occurred in 82 of 194 ablation sessions (42.3%). Thirty-three of 82 sessions had either delayed pneumothorax (n = 20) or recurrent pneumothorax (n = 13). The other 49 sessions had nonprogressive pneumothorax. Only contact of the ground-glass opacity (GGO) that emerged around the ablated lesion with the pleura significantly correlated with the frequency of delayed or recurrent pneumothorax in comparisons between no pneumothorax vs delayed/recurrent pneumothorax and between nonprogressive pneumothorax vs delayed/recurrent pneumothorax. The mean (± SD) duration before confirmation of the presence or recurrence of pneumothorax was 24.0 ± 66.4 h. Among the 33 sessions with delayed or recurrent pneumothorax, 4 subjects needed additional treatment.

Conclusion:  Our results indicated that delayed or recurrent pneumothorax is relatively frequently encountered after RF ablation of lung tumors. Particular care must be taken with regard to the occurrence of delayed or recurrent pneumothorax when contact of a GGO with the pleura is seen after RF ablation.

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