Artificial Pneumothorax With Position Adjustment for Computed Tomography-Guided Percutaneous Core Biopsy of Mediastinum Lesions

Purpose. This study was designed to assess the use of artificial pneumothorax with position adjustment to gain a pleural space approach in computed tomographic-guided core biopsy of mediastinal masses. Description. Eleven patients with mediastinal lesions who were undergoing percutaneous core biopsies received an artificial pneumothorax with a 22-gauge lumbar puncture needle. Each patient's position was adjusted to place the lesion as high as possible in the thoracic cavity. Air was injected until the lung was displaced from the path of the biopsy needle. After completion of the biopsy, a comparable volume of air was aspirated. Evaluation. In all patients, satisfactory displacement of the lung from the biopsy site was achieved with the artificial pneuomothorax procedure enabling the target lesion to be reached. No postoperative air leaks requiring tube drainage were encountered. Conclusions. Artificial pneumothorax with position adjustment is a safe and effective method that provides access for computed tomographic-guided biopsy of mediastinal lesions without the risks of traversing aerated lung tissue and with a relatively low volume of injected air.