Surgeon-led Point-of-care Ultrasound-guided Thoracic Biopsy: A new paradigm in efficient diagnosis and resource-sparing care

作者：Vaibhav Gupta, Stephen Gowing, Rudra Pandya, Lawrence Tan, Richard Y. Liu, Sadeesh Srinathan, Biniam Kidane · 发表于：Journal of Thoracic and Cardiovascular Surgery · 年份：2024 · DOI：10.1016/j.jtcvs.2024.11.039 · 被引用次数：8 · 研究领域：Ultrasound in Clinical Applications、Lung Cancer Diagnosis and Treatment、Amoebic Infections and Treatments

OBJECTIVE: Tissue diagnosis through a variety of interventional approaches guides thoracic cancer management, but often introduces delay to definitive treatment and can be resource intensive. We introduced a thoracic surgeon-led, point-of-care ultrasound-guided biopsy program to provide rapid diagnosis for patients with thoracic cancers. We assessed the diagnostic yield and adverse events with this approach. METHODS: A prospective cohort study was performed of consecutive patients undergoing ultrasound-guided biopsies performed by 5 thoracic surgeons from June 2021 to April 2024 at a tertiary Canadian thoracic surgery institution. By using a bedside ultrasound, 20-gauge tissue cores were obtained using multiple passes with a standard spinal needle. Descriptive univariable statistics were used. RESULTS: A total of 160 patients underwent bedside biopsy for lung (n = 101), liver (n = 20), chest wall/pleural (n = 20), mediastinal (n = 18), or other (n = 1) lesions. Tissue diagnosis was obtained in 86.3% of patients (n = 138), and diagnostic yield was similar for high- and low-volume providers and over time. All liver biopsies were diagnostic. Nondiagnostic biopsies were more likely to occur with benign pathology, chest wall/pleural lesions, or extensive necrosis; diagnosis was achieved with other modalities in most cases. There was 1 postprocedure pneumothorax (adverse event rate 0.6%). CONCLUSIONS: Thoracic surgeon-led ultrasound-guided biopsies are safe in an outpatient clinic ...