Percutaneous transthoracic biopsy of the basal lung formations using a coaxial system and CT navigation

Introduction. The task of histological verification of the pathological process in the central part of the lung root, on the periphery and in the basal zone of the lung is extremely difficult. In the modern world, preferences are given to minimally invasive methods of obtaining morphological material. Transthoracic biopsy of lung formations under the control of computed tomography is the method of choice for verifying peripheral neoplasms with a relatively low percentage of postmanipulation complications (6-9%). However, with a biopsy of basal lung neoplasms, due to an increase in thethickness of the parenchyma to the biopsied focus, the percentage of postmanipulation complications increases significantly to 15-22%.The purpose of the study: to evaluate the effectiveness of transthoracic biopsy of the basal lung formations using computed tomography in combination with a coaxial system as navigation, to analyze the nature and frequency of postmanipulation complications and to determine the diagnostic value of the proposed technique. Material and methods. From December 2018 to December 2021, 316 primary patients underwent percutaneous transthoracic biopsy of the basal lung formations under CT control and using a coaxial system for histological verification in the Department of Thoracic Surgery of the G.E. Ostroverkhov Medical Center. Results. The duration of the manipulation varied from 9 to 23 minutes (16 ± 2.3 minutes). Twenty- two patients (6.9%) developed postmanipulatory complications, such as hemoptysis and pneumothorax. In 97.2% of patients, it was possible to obtain informative histological material and verify the diagnosis morphologically. The sensitivity, specificity and accuracy of the proposed technique were 97%, 100% and 97%, respectively. Conclusion. Taking into account the low frequency of postmanipulation complications (6.9%), the use of a coaxial system with permanent anesthesia in transthoracic biopsies of basal lung formations under the control of computed tomography is a safe minimally invasive method of morphological verification. The use of this verification technique makes it possible to obtain high-quality highly informative morphological material sufficient for immunohistochemical examination without the use of invasive operational verification methods.