Lung India最新文献

Introduction and objective: CT-guided percutaneous lung biopsy is a widely used diagnostic tool for pulmonary lesions, but it carries a significant risk of pneumothorax. Various techniques have been explored to minimize this complication, including the use of autologous intraparenchymal blood patching. This study aims to evaluate the effectiveness of parenchymal blood patching in reducing pneumothorax rates in percutaneous CT-guided lung biopsies.

Materials and method: This retrospective study included all patients who underwent percutaneous CT-guided lung biopsy at a tertiary care hospital in Northeast India, from January 2023 to January 2025. Patients were categorized into two groups: those who did not receive a blood patch and those who received a blood patch.

Results and conclusion: A total of 121 patients who underwent CT-guided lung biopsy were included in the study. Among the 39 patients who did not receive a parenchymal blood patch, pneumothorax occurred in 12 cases (30.7%), of which 7 required chest tube drainage and 5 underwent aspiration. In contrast, among the 82 patients who received a parenchymal blood patch, pneumothorax developed in 7 cases (8.5%). Of these, 5 patients required chest tube drainage, while 2 had minimal, non-progressive pneumothorax that required no intervention. Hospitalization was needed in 7 patients in the non-blood patch group and in 5 patients in the blood patch group. A chi-square test showed a statistically significant reduction in pneumothorax incidence in the blood patch group (P = 0.04). However, no statistically significant difference was found in hospitalization rates between the two groups (P = 0.32). Parenchymal blood patching is an effective technique in CT-guided lung biopsies, significantly reducing pneumothorax rates.

Background and objective: Pneumothorax presents the significant clinical and public health challenge in the Kashmir region due to the unique geographical, demographic, and socioeconomic factors. This study analyses the clinical patterns, etiological factors, management strategies, and outcomes of 650 pneumothorax cases treated at a tertiary care centre in Kashmir. This study aims to evaluate the clinical patterns, etiological factors, diagnostic approaches, management strategies, and outcomes of pneumothorax cases in the Kashmir region. By analysing a large dataset from a tertiary care centre, the study seeks to highlight region-specific challenges and propose improvements in diagnostic and therapeutic strategies to enhance patient care.

Materials and methods: An ambispective analysis of 650 cases of pneumothorax from January 2020 to July 2024 was conducted. Patients were classified as having traumatic, spontaneous, or iatrogenic pneumothorax. Data on demographic distribution, clinical presentation, associated injuries, management approaches, complications and outcomes were analysed using descriptive statistics.

Results: Traumatic pneumothorax was the most common type (61.5%, n = 400), with unilateral presentation in 67.5% of cases. Spontaneous pneumothorax accounted for 21.5% (n = 140), of which secondary causes predominated (54.3%). Iatrogenic pneumothorax comprised 16.9% (n = 110). Chest radiography (CxR) was the primary diagnostic tool (100%), with CT scanning required in 28.5% of cases. Ultrasound showed 89.2% sensitivity in emergency settings. Intercostal tube drainage (ICTD) was the mainstay of treatment in 78.5% of cases, yielding a success rate of 94.5%. Complications included persistent air leak (12%), empyema (3.7%), and recurrence (6.3%).

Conclusion: Our study provides a comprehensive analysis of pneumothorax in the Kashmir region, highlighting its unique etiological and clinical patterns. The findings emphasize the need for improved trauma care systems, standardized treatment protocols, and widespread training in emergency procedures, particularly in rural and resource-limited settings, to optimize patient outcomes and reduce complications.

Providing a satisfactory lung isolation during the video-assisted thoracoscopic surgery in infants can be challenging due to the limited options for one lung ventilation. Additional anatomic pathologies/derangements add to the complexity in managing the airway in these tiny infants. We discuss a case of a 10-month infant scheduled for video-assisted excision of a recurrent bronchogenic cyst that was in proximity to recurrent laryngeal nerves, compressing the trachea and bronchus. The associated severe tracheo-bronchomalacia and the risk of an inadvertent recurrent laryngeal nerve injury demanded a need to exercise caution and necessitated a personalised approach to aid surgery. This article aims to outline the several airway challenges encountered intraoperatively in this infant and thereby contribute to the literature on the management of such cases. While it is imperative to tailor the management strategies to individual case, we endeavour to navigate the intricate complexities and ensure optimal patient outcomes.