.: ORİJİNAL ARAŞTIRMA
Üçüncü Basamak Bir Göğüs Hastalıkları Kliniğinde Tanısal İşlemlerde Torasik Ultrasonografi: Retrospektif Gözlemsel Çalışma
Thoracic Ultrasonography in Diagnostic Procedures in a Tertiary Pulmonology Clinic: Retrospective Observational Study
Turkiye Klinikleri Arch Lung. 2023;22(2):19-26
doi: 10.5336/archlung.2023-98572
Makale Dili: TR
Tam Metin
ÖZET
Amaç: Torasik ultrasonografi (USG) rehberliğinde yapılan girişimsel işlemlerin özelliklerini incelemek. Gereç ve Yöntemler: Ocak 2021-Aralık 2022 tarihleri arasında torasik USG rehberliğinde işlem yapılan olguların dosyaları geriye dönük olarak incelendi. Olguların klinik-demografik, radyolojik bulguları kayıt edildi. Torasik USG rehberliğinde yapılan tüm tanısal işlemler, var ise işlem sonrası komplikasyonlar kayıt edildi. Bulgular: Çalışmaya yaş ortalaması 69,3±12,1 olan, 45'i (%36,3) kadın, 79'u (%63,7) erkek olmak üzere toplam 124 olgu dâhil edildi. Seksen bir (%65,3) olguya torasentez amaçlı, 33 (%26,6) olguya biyopsi amaçlı, 10 (%8,1) olguya plevral kateter takılması amacı ile torasik USG yapıldı. Torasentez işlemleri incelendiğinde; 61 (%49,1) olguya tanısal torasentez, 20 (%16,1) olguya terapötik amaçlı torasentez yapıldığı görüldü. Biyopsi işlemleri incelendiğinde, akciğerde primer kitle lezyonu olan 20 (%16,1) olguya USG rehberliğinde transtorasik ince iğne aspirasyon biyopsisi (TTİAB) yapıldığı, akciğerde primer kitle lezyonu olup göğüs duvarı metastazı olan 5 (%4) olguya göğüs duvarı lezyonuna TTİAB, yine primer akciğer malignitesi şüphesi olup supraklavikular lenfadenopatisi (LAP) tespit edilen 3 (%2,4) olguya supraklavikular LAP'a İAB yapıldığı, ayrıca plevral sıvı nedeni ile tetkik edilip plevral biyopsi endikasyonu koyulan 5 (%4) olguya da USG rehberliğinde plevral tru-cut biyopsi yapıldığı görüldü. Sonuç: Seçilmiş olgularda ve girişimsel işlemlerde torasik USG'nin tanı başarısı yüksektir ve USG rehberliğinde yapılan girişimsel işlemlerde komplikasyon oranı düşüktür.
Anahtar Kelimeler: Biyopsi; torasentez; torasik ultrasonografi
Amaç: Torasik ultrasonografi (USG) rehberliğinde yapılan girişimsel işlemlerin özelliklerini incelemek. Gereç ve Yöntemler: Ocak 2021-Aralık 2022 tarihleri arasında torasik USG rehberliğinde işlem yapılan olguların dosyaları geriye dönük olarak incelendi. Olguların klinik-demografik, radyolojik bulguları kayıt edildi. Torasik USG rehberliğinde yapılan tüm tanısal işlemler, var ise işlem sonrası komplikasyonlar kayıt edildi. Bulgular: Çalışmaya yaş ortalaması 69,3±12,1 olan, 45'i (%36,3) kadın, 79'u (%63,7) erkek olmak üzere toplam 124 olgu dâhil edildi. Seksen bir (%65,3) olguya torasentez amaçlı, 33 (%26,6) olguya biyopsi amaçlı, 10 (%8,1) olguya plevral kateter takılması amacı ile torasik USG yapıldı. Torasentez işlemleri incelendiğinde; 61 (%49,1) olguya tanısal torasentez, 20 (%16,1) olguya terapötik amaçlı torasentez yapıldığı görüldü. Biyopsi işlemleri incelendiğinde, akciğerde primer kitle lezyonu olan 20 (%16,1) olguya USG rehberliğinde transtorasik ince iğne aspirasyon biyopsisi (TTİAB) yapıldığı, akciğerde primer kitle lezyonu olup göğüs duvarı metastazı olan 5 (%4) olguya göğüs duvarı lezyonuna TTİAB, yine primer akciğer malignitesi şüphesi olup supraklavikular lenfadenopatisi (LAP) tespit edilen 3 (%2,4) olguya supraklavikular LAP'a İAB yapıldığı, ayrıca plevral sıvı nedeni ile tetkik edilip plevral biyopsi endikasyonu koyulan 5 (%4) olguya da USG rehberliğinde plevral tru-cut biyopsi yapıldığı görüldü. Sonuç: Seçilmiş olgularda ve girişimsel işlemlerde torasik USG'nin tanı başarısı yüksektir ve USG rehberliğinde yapılan girişimsel işlemlerde komplikasyon oranı düşüktür.
Anahtar Kelimeler: Biyopsi; torasentez; torasik ultrasonografi
ABSTRACT
Objective: To examine the characteristics of interventional procedures performed under the guidance of thoracic ultrasonography (USG). Material and Methods: The files of the cases who underwent procedures under thoracic USG guidance between January 2021 and December 2022 were examined retrospectively. Clinical-demographic and radiological findings of the cases were recorded. All diagnostic procedures performed under the guidance of thoracic USG and post-procedural complications, if any, were recorded. Results: A total of 124 cases, 45 (36.3%) women and 79 (63.7%) men, with a mean age of 69.3±12.1 years, were included in the study. Thoracic USG was performed for thoracentesis in 81 (65.3%) cases, for biopsy in 33 (26.6%) cases, and for pleural catheter insertion in 10 (8.1%) cases. When thoracentesis procedures were examined, it was seen that diagnostic thoracentesis was performed in 61 (49.1%) cases and therapeutic thoracentesis was performed in 20 (16.1%) cases. When the biopsy procedures were examined, USG-guided transthoracic fine needle aspiration biopsy (TTNAB) was performed in 20 (16.1%) cases with a primary mass lesion in the lung, and TTNAB was performed on the chest wall lesion in 5 (4%) cases with a primary mass lesion in the lung and chest wall metastasis. Again, NAB was performed on supraclavicular LAP in 3 (2.4%) cases with supraclavicular lymphadenopathy (LAP) and suspicion of primary lung malignancy. In addition, pleural tru-cut biopsy was performed under USG guidance in 5 (4%) cases who were examined for pleural fluid and indicated for pleural biopsy. Conclusion: The diagnostic success rate of thoracic USG is high in selected cases and interventional procedures, and the complication rate is low in USG-guided interventional procedures.
Keywords: Biopsy; thoracentesis; thoracic ultrasonography
Objective: To examine the characteristics of interventional procedures performed under the guidance of thoracic ultrasonography (USG). Material and Methods: The files of the cases who underwent procedures under thoracic USG guidance between January 2021 and December 2022 were examined retrospectively. Clinical-demographic and radiological findings of the cases were recorded. All diagnostic procedures performed under the guidance of thoracic USG and post-procedural complications, if any, were recorded. Results: A total of 124 cases, 45 (36.3%) women and 79 (63.7%) men, with a mean age of 69.3±12.1 years, were included in the study. Thoracic USG was performed for thoracentesis in 81 (65.3%) cases, for biopsy in 33 (26.6%) cases, and for pleural catheter insertion in 10 (8.1%) cases. When thoracentesis procedures were examined, it was seen that diagnostic thoracentesis was performed in 61 (49.1%) cases and therapeutic thoracentesis was performed in 20 (16.1%) cases. When the biopsy procedures were examined, USG-guided transthoracic fine needle aspiration biopsy (TTNAB) was performed in 20 (16.1%) cases with a primary mass lesion in the lung, and TTNAB was performed on the chest wall lesion in 5 (4%) cases with a primary mass lesion in the lung and chest wall metastasis. Again, NAB was performed on supraclavicular LAP in 3 (2.4%) cases with supraclavicular lymphadenopathy (LAP) and suspicion of primary lung malignancy. In addition, pleural tru-cut biopsy was performed under USG guidance in 5 (4%) cases who were examined for pleural fluid and indicated for pleural biopsy. Conclusion: The diagnostic success rate of thoracic USG is high in selected cases and interventional procedures, and the complication rate is low in USG-guided interventional procedures.
Keywords: Biopsy; thoracentesis; thoracic ultrasonography
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