Journal of vascular and interventional radiology : JVIR · 2026
Predictors of Bronchopleural Fistula after Percutaneous Microwave Ablation of Lung Tumors.
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Zhong Jun-Sheng, Chen Jin, Lin Zheng-Yu
Аннотация
PURPOSE: To investigate the risk factors for bronchopleural fistula (BPF) following computed tomography (CT)-guided percutaneous microwave ablation (MWA) for lung tumors.
MATERIALS AND METHODS: Consecutive patients treated between April 2018 and December 2024 were retrospectively reviewed. A total of 1,041 patients were enrolled and divided into a BPF group (n = 15) and a control group (n = 1,026) according to the development of postoperative BPF. Univariate analysis was employed to identify potential risk factors, followed by Lasso regression to exclude collinear variables. Subsequently, multivariate logistic regression analysis was conducted to determine the independent risk factors for BPF and presented in a forest plot.
RESULTS: The incidence of BPF was approximately 1.4%. Univariate analysis revealed the following risk factors for BPF: target-pleura distance of <2.5 cm (P < .01), pleural contraction during ablation (P < .01), tumor-pleura fibrous traction (P = .01), tumor-to-pleura distance of ≤1 cm (P = .02), and postoperative pulmonary/pleural infection (P < .01). Lasso regression revealed 3 key variables from 21 candidates: target-pleura distance of <2.5 cm, pleural contraction during ablation, and postoperative pulmonary/pleural infection. Furthermore, multivariate logistic regression analysis revealed that the aforementioned factors were independent risk factors for BPF following percutaneous lung tumor MWA: target-pleura distance of <2.5 cm (odds ratio [OR], 2.27; 95% confidence interval [CI], 1.51-3.42; P < .01), pleural contraction during ablation (OR, 2.14; 95% CI, 1.57-2.92; P < .01), and postoperative pulmonary/pleural infection (OR, 3.89; 95% CI, 1.98-7.64; P < .01).
CONCLUSIONS: Preventive measures such as maintaining a ≥2.5-cm target-pleura distance, minimizing pleural injury, and implementing rigorous infection control may contribute to lowering the incidence of BPF.
MATERIALS AND METHODS: Consecutive patients treated between April 2018 and December 2024 were retrospectively reviewed. A total of 1,041 patients were enrolled and divided into a BPF group (n = 15) and a control group (n = 1,026) according to the development of postoperative BPF. Univariate analysis was employed to identify potential risk factors, followed by Lasso regression to exclude collinear variables. Subsequently, multivariate logistic regression analysis was conducted to determine the independent risk factors for BPF and presented in a forest plot.
RESULTS: The incidence of BPF was approximately 1.4%. Univariate analysis revealed the following risk factors for BPF: target-pleura distance of <2.5 cm (P < .01), pleural contraction during ablation (P < .01), tumor-pleura fibrous traction (P = .01), tumor-to-pleura distance of ≤1 cm (P = .02), and postoperative pulmonary/pleural infection (P < .01). Lasso regression revealed 3 key variables from 21 candidates: target-pleura distance of <2.5 cm, pleural contraction during ablation, and postoperative pulmonary/pleural infection. Furthermore, multivariate logistic regression analysis revealed that the aforementioned factors were independent risk factors for BPF following percutaneous lung tumor MWA: target-pleura distance of <2.5 cm (odds ratio [OR], 2.27; 95% confidence interval [CI], 1.51-3.42; P < .01), pleural contraction during ablation (OR, 2.14; 95% CI, 1.57-2.92; P < .01), and postoperative pulmonary/pleural infection (OR, 3.89; 95% CI, 1.98-7.64; P < .01).
CONCLUSIONS: Preventive measures such as maintaining a ≥2.5-cm target-pleura distance, minimizing pleural injury, and implementing rigorous infection control may contribute to lowering the incidence of BPF.