Use of ultrasound-guided thoracentesis to reduce iatrogenic risk of pneumothorax in patients with cancer.

e19582 Background: Thoracentesis is an essential procedure in an attempt to delineate the etiology of the fluid collection or to relieve symptoms in oncologic patients. One of the most common complication of thoracentesis is pneumothorax, which has been reported to occur in 2%-30% of thoracenteses, with 15%-50% of these patients requiring tube thoracostomy. Methods: To assess whether thoracenteses performed with ultrasound (US) guidance are associated with a lower rates of pneumothorax and tube thoracostomy than those performed without US guidance, we reviewed the medical records of 445 patients with cancer undergoing thoracentesis. Results: From January 2004 to January 2009, in 310 patients (69,60%) thoracentesis was performed with US guidance and 135 (30, 40%) without it. On post thoracentesis imaging performed in all cases, 15 pneumothoraces (3,40%) were found, 3 of them (0,67%) required tube thoracostomy. Pneumothorax accured in 4 of 310 procedure (1,3%) performed with US guidance and 11 of 135 procedure (8%) performed without it. Tube thoracostomy was performed in 3 patients; it must be emphazised that in all these 3 cases thoracentesis was performed without US guidance Conclusions: The routine use of US during thoracentesis drastically reduce rate of pneumothorax and tube thoracostomy in oncologic patients, as demostrated in our study.