Ultrasound-Guided Transthoracic Mediastinal Biopsy: A Safe Technique for Tissue Diagnosis in Middle- and Low-Income Countries

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Ultrasound-Guided Transthoracic Mediastinal Biopsy: A Safe Technique for Tissue Diagnosis in Middle- and Low-Income Countries


Journalcureus
Article typeJournal research article – Clinical research
Publication date – Mar – 2021
Authors – Muhammad Kashif Shazlee, Muhammad Ali, Muhammad Saad Ahmed, Junaid Iqbal, Jaideep Darira, Muhammad Qasim Naeem
Keywordsmediastinal biopsy associated mortality, mediastinal biopsy related complications, mediastinal mass, mediastinal tumours, ultrasound guided transthoracic mediastinal biopsy
Open access – Yes
SpecialityCardiothoracic surgery, Other, Surgical oncology
World region Southern Asia
Country: Pakistan
Language – English
Submitted to the One Surgery Index on March 26, 2021 at 5:32 am
Abstract:

Background and objectives
The high cost of video-assisted transthoracic procedures precludes their use in the diagnostics of mediastinal masses in low- and middle-income countries (LMICs). This study aims to assess the technical success rate and diagnostic yield of ultrasound-guided transthoracic mediastinal biopsies at a tertiary care hospital.

Methods
This descriptive cross-sectional study was conducted in patients presenting with mediastinal masses referred to radiology services at Dr. Ziauddin University Hospital. Karachi, Pakistan. Ultrasonography was performed using Toshiba Xario 200 & Aplio 500 using convex and linear probes accordingly. Biopsy was performed using a combination of 18G semiautomatic trucut and 17G co-axial needles. Complications and overall diagnostic yields were determined.

Results
In all 70 patients referred, the procedure was completed successfully with an overall procedural yield of 95.7%. Inconclusive biopsies due to inadequate specimen were seen in two (4.2%) patients. No post-procedure major complication or mortality was observed. Minor complications were seen in three (4.2%) out of 70, including hematoma (<3 cm) in one patient and small pneumomediastinum in two patients.

Conclusion
Ultrasound-guided transthoracic mediastinal biopsy may be the pragmatic technique of choice in LMICs for the diagnosis of mediastinal masses as they provide real-time visualization and is cost-effective and safe

OSI Number – 20977

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