Pneumothorax and dependent versus nondependent patient position after needle biopsy of the lung

PURPOSE: To test the hypothesis that placing the patient in a position with the puncture site dependent (down) after transthoracic needle biopsy reduc es the incidences of pneumothorax and of pneumothorax that requires chest t ube placement. MATERIALS AND METHODS: Four hundred twenty-three needle biopsies of the lun g were performed in 390 patients from October 1991 to August 1994 with comp uted tomographic guidance, fluoroscopic guidance, or both. Two hundred fort y-two biopsies were performed from the posterior approach, 166 from the ant erior approach, and 15 from the lateral approach. The patients were assigne d on an alternating basis to either the puncture-site-dependent recumbent p osition (210 biopsies) or the puncture-site-nondependent recumbent position (213 biopsies) for at least 1 1/2 hours after biopsy. RESULTS: No significant differences were found in either the incidence of p neumothorax (dependent position, 62 of 210 biopsies [30%], vs nondependent position, 57 of 213 biopsies [27%]; P = .60) or the incidence of pneumothor ax that required chest tube placement (dependent position, 10 of 210 biopsi es [5%], vs nondependent position, six of 213 biopsies [3%]; P = .43). CONCLUSION: The results suggest that the puncture-site-down postbiopsy posi tion may hot affect either the incidence of postbiopsy pneumothorax or the incidence of pneumothorax that requires chest tube placement.