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KMID : 0616620030090020185
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Journal of Soonchunhyang Medical College
2003 Volume.9 No. 2 p.185 ~ p.196
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The Experimental Study of Prevention of Pneumothorax after Percutaneous Transthoracic Fine Needle biopsy -Using the Histoacryl® Injection.
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Im Han-Hyeok
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Abstract
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Purpose: Percutaneous transthoracic needle aspiration(PTNA) has been used as a excellent diagnostic mathod due to it’s safety and accuracy in many thoracic lesion. But the major complication of PTNA is still pneumothorax in spite of advance of skill and use fine needle. To prevent the pneumothorax after PTNA, we tried Histoacryl^(®) injection through biopsy needle after aspiration of specimen. Histoacryl^(®) is a deriative of cyanoacrylate and used as a tissue adhesive. Such effect of Histoacryl^(®) observed on PTNA model of rabbits.
Material and Methods: In 40 adult rabbits(20 contral group. 20 study group), intramuscular injection of ketamine 15㎎/㎏ for anesthesia and 3㎜ endotracheal intubation tube was inserted in the trachea after tracheostomy. Ambu-bagging with 10㎜Hg end expiratory pressure was started. On the supine position, routine percutaneous transthoracic needle aspiration was performed in control group. In study group, Histioacryl^(®) was injected into lung parenchym at 6th intercostal space on midclavicular line before needle withdrawl. Depth of needle was 1.5㎝ and PTNA sites were in 10 cases, right and 10 cases, left in each group. The amounts of injected Histoacryl^(®) was 0.1㏄ in 7 cases, 0.2㏄ in 7 cases, 0.4 ㏄ in 6 cases. After 10 minutes, HRCT was done and inspected pneumothorax amount and rechecked HRCT after 7 days. Rabbits were sacrified and histopathologic evaluation was done after 7 days.
Result: Pneumothorax developed 19 cases in control group and just 4 cases in study group. Control group is developed much higher incidence and severity of pneumothorax than that of study group. Increased amount of Histioacryl^(®) substance is not effective to prevent the pneumothorax and more complicated result on follow-up study. Histopathologic findings were revealed a little inflamatory reaction and lung parenchymal fibrosis and pleural adhesion.
Conclusion: In animal study of artificial COPD lung condition, Histioacryl^(®) injection is effective to prevent the pneumothorax after PTNA.
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