Evaluation of Pleural Vents Inserted by Radiologists Versus Intercostal Chest Drains Managed by Respiratory Physicians for Post-CT-Guided Lung Biopsy Pneumothorax at Glan Clwyd Hospital, Wales.

Introduction CT-guided biopsy (CTGB) of the lung is a commonly performed, minimally invasive procedure used to obtain tissue samples from suspected malignant lung lesions. Pneumothorax is a recognised complication of CTGB. Management typically involves observation, intercostal chest drain insertion, or pleural vent placement. Traditional intercostal chest drains often require unplanned hospital admission, whereas pleural vents allow patient mobility and may reduce inpatient care. Objective The primary aim of this study was to compare hospital length of stay in patients managed with pleural vents inserted by radiologists versus intercostal chest drains managed by respiratory physicians for post-CTGB pneumothorax. Materials and methods A retrospective analysis was conducted of 98 scheduled CT-guided biopsies performed over a one-year period at Glan Clwyd Hospital, Wales. Seventeen cases were excluded due to lesion resolution, procedure abandonment, biopsies outside the lungs, medically unfit for biopsy, or inaccessible biopsy sites, leaving 81 biopsies for analysis. Results Among the 81 patients, 39 experienced complications, including 30 pneumothoraces and nine haemothoraces. Nine patients with pneumothorax required intervention: four were managed with pleural vents inserted by the operating radiologist, and five received intercostal chest drains inserted by the respiratory team. The modal length of stay was one day for pleural vent patients and three days for chest drain patients. Conclusion Pleural vents were associated with a shorter modal length of hospital stay (one day) compared with intercostal chest drains (three days) for post-CTGB pneumothorax. Whilst limited by its single-centred, observational nature, this study provides useful real-world insight into current pneumothorax management by radiologists and respiratory physicians. Further prospective multicentre research is needed to validate the potential advantage of pleural vents over intercostal chest drains and support the development of standardised protocols and potential outpatient pathways for CTGB pneumothorax management.