2016 Volume 38 Issue 6 Pages 476-484
Background and Objective. Lung abscess after transbronchial biopsy is a serious complication for lung cancer patients. Prophylactic antibiotics have been administered after transbronchial biopsy since 2007 at Showa University Northern Yokohama Hospital to prevent lung abscess accompanying lung cancer. This study attempted to examine the incidence and risk factors of the complications and estimate the efficacy of these prophylactic antibiotics. Methods. From April 2001 to March 2013, 783 patients with peripheral lung cancer underwent bronchoscopic biopsy under X-ray fluoroscopy. We classified patients into the lung abscess complicated group and the non-complicated group and estimated the risk factors for complication using univariate and multivariate analyses. We further classified patients into the early period (April 2001 to March 2007, n=255) or later period group (April 2007 to March 2013, n=528), and retrospectively examined the incidence of lung abscess complicating transbronchial biopsy in each group. Results. During this period, 9 patients (1.1%) developed lung abscesses as a complication. The multivariate analysis identified central necrosis and cavitary lesions as significant risk factors for lung abscess after transbronchial biopsy. The incidence in the later period group was significantly lower than in the early period group (2.4% vs. 0.6%; p=0.028). The incidence of central necrosis or cavitary lesions was significantly higher than for other radiological findings (3.3% vs. 0.6%; p=0.018). With regard to central necrosis or cavitary lesions, although not statistically significant, the incidence in the prophylactic antibiotics group (1.8%) was lower than in the no prophylactic treatment group (7.9%). Conclusion. The risk factors for development of a lung abscess after transbronchial biopsy were having a mass with central necrosis or cavitary lesions. The prophylactic administration in patients with these risk factors is reasonable.
