{
  "abstract": "Introduction CT-guided lung biopsy is the most important test to diagnose early-stage lung cancer but it is complicated by pneumothorax in 1 in 4 patients. There are no treatment guidelines for the management of pneumothorax after lung biopsy leading to significant variability in clinical practice. We conducted a systematic review of the literature to investigate the optimal management of pneumothorax after lung biopsy.Methods A literature search was conducted in 4 databases (Ovid MEDLINE, EMBASE, Cochrane CENTRAL and Cochrane database of Systematic Reviews) from inception till Dec’24 using a defined search strategy. Published Randomised controlled trials (RCTs) and case series of >200 adult patients undergoing lung biopsy were searched in English language. The main outcome was type of treatment, reason of choosing the treatment option, time to pneumothorax resolution and the length of stay in hospital. All articles were reviewed by two independent reviewers at each stage and data was extracted from eligible studies.Results A total of 1950 articles were retrieved based on the search strategy. 193 articles were eligible for the full-text review and 28 were included comprising 4 RCTs and 24 case series with a total of 10, 818 patients. 2592 patients developed a pneumothorax after lung biopsy with an incidence of 23.96%. Mean age was 59 years and 5267 (48.69%) patients were male. Pneumothorax was drained in 293/2592 (11.3%) patients using a chest drain, 312/2592(12%) patients with a needle aspiration, 111/2592(4.3%) patients requiring needle aspiration or conservative care followed by chest drainage and 568/2592(21.9%) were treated with conservative care alone. The main reason of treatment was size of pneumothorax (24 studies), presence of symptoms (16 studies) and enlarging pneumothorax (9 studies). 6 studies mentioned time to resolution of pneumothorax ranging from 3.7 hours to 9 days. Length of stay in hospital was not recorded.Conclusion This is the first-ever systematic review of the literature to understand the management of pneumothorax after lung biopsy. Size of pneumothorax, despite being less relevant in spontaneous pneumothorax, remains an important factor to guide management and there is a need to develop robust prospective data.",
  "authors": [
    {
      "affiliations": [
        "Oxford Respiratory Trials Unit, Oxford, UK"
      ],
      "name": "B Iqbal"
    },
    {
      "affiliations": [
        "Oxford Respiratory Trials Unit, Oxford, UK"
      ],
      "name": "A Sundaralingam"
    },
    {
      "affiliations": [
        "Oxford Respiratory Trials Unit, Oxford, UK"
      ],
      "name": "D Addala"
    },
    {
      "affiliations": [
        "Oxford Respiratory Trials Unit, Oxford, UK"
      ],
      "name": "A Elsheikh"
    },
    {
      "affiliations": [
        "Oxford University Hospital NHS Foundation Trust, Oxford, UK"
      ],
      "name": "M Bhatnagar"
    },
    {
      "affiliations": [
        "Oxford University Hospital NHS Foundation Trust, Oxford, UK"
      ],
      "name": "N Kaushal"
    },
    {
      "affiliations": [
        "Oxford University Hospital NHS Foundation Trust, Oxford, UK"
      ],
      "name": "S Kette"
    },
    {
      "affiliations": [
        "Oxford University Hospital NHS Foundation Trust, Oxford, UK"
      ],
      "name": "C Mounsey"
    },
    {
      "affiliations": [
        "Oxford Respiratory Trials Unit, Oxford, UK"
      ],
      "name": "NM Rahman"
    },
    {
      "affiliations": [
        "Oxford Respiratory Trials Unit, Oxford, UK"
      ],
      "name": "RJ Hallifax"
    }
  ],
  "title": "P81 ‘’Knowing the unknown’’: a systematic review of literature investigating the optimal management of pneumothorax after CT-guided lung biopsy",
  "uid": "80b3d7f6-5393-5603-82c4-4576827e3a25"
}