PURPOSE: To determine the safety of early discharge (30 minutes) after tran
sthoracic needle biopsy (TTNB) of the lung.
MATERIALS AND METHODS: In a prospective study of 506 consecutive outpatient
s who underwent TTNB of the lung, 440 patients underwent fine-needle aspira
tion biopsy (FNAB) only, and 66 underwent FNAB and core biopsy. Patients we
re discharged after 30-minute postbiopsy chest radiography if there was no
pneumothorax. Patients were discharged after 60-minute chest radiography if
they had a stable asymptomatic pneumothorax. These patients were followed
up 1 day and/or 1 week after biopsy to identify delayed complications. Pati
ents with a symptomatic or enlarging pneumothorax were treated with an 8-F
pigtail catheter attached to a Heimlich valve, discharged, and followed up
24 hours later for chest tube removal.
RESULTS: The pneumothorax rate was 22.9% (116 patients). Eighty-one patient
s (16.0%) had an asymptomatic pneumothorax, and 33 (6.5%) had a pigtail cat
heter in place. Seven (1.4%) patients developed a symptomatic pneumothorax
after discharge; two of them (0.4%) underwent large-bore chest tube inserti
on. The other five (1.0%) underwent delayed pigtail catheter insertion. The
re Were no deaths or other major complications.
CONCLUSION: Early discharge after outpatient TTNB of the lung is associated
with little morbidity and no mortality.