Efficacy and Safety of Tract Cauterization for Lung Cryoablation

To evaluate the safety and efficacy of tract cauterization for lung cryoablation through comparison of post-procedure complication rate.

Materials and Methods:

This IRB-approved, HIPAA compliant study cohort involved patients who underwent lung cryoablation for their malignancy between 2013 to 2018 under one thoracic radiologist. All patient demographics, number of tumors, type of probes, duration of freeze-thaw cycles were collected. The study cohort was subdivided into whether tract cauterization was conducted post lung cryoablation. Complication rates were assessed with immediate and delayed (more than one month) post-ablation pneumothorax, hemothorax, pleural effusion, and types of interventions. A logistical regression model was used to compare differences in complication rates.

Results: The study cohort was composed of 164 patients (mean age: 65.4 ± 11.3) who underwent lung cryoablation either with or without tract cauterization. Of these patients, 42 experienced post-ablation pleural effusion, 5 experienced hemothorax, 75 experienced pneumothorax, and 19 received interventions such as chest tube placement to treat these complications. Patients who received tract cauterization were 2.551 times less likely to exhibit post-ablation pleural effusion than patients who did not receive cauterization (p = 0.017). For every increase in number of probes, patients were 1.639 times more likely to experience post-ablation pneumothorax (p = 0.035), 2.286 times more likely to experience pleural effusion (p = 0.002), and 3.775 times more likely to receive post-procedure interventions (p < 0.001).

Conclusion: Utilizing tract cauterization with lung cryoablation shows reduced incidence of post-ablation pleural effusion. Minimizing the number of cryoprobes used decreases the risk of post-procedure complications and interventions.