Safety and Effectiveness of Track Cauterization for Lung Cryoablation

Purpose To evaluate the safety and efficacy of track cauterization for lung cryoablation through comparison of post-procedural adverse event (AE) rates. Material and methods Fifty-nine patients who underwent 164 percutaneous lung cryoablation between 2013 to 2018 were included in this retrospective study. The study cohort was subdivided into whether track cauterization was conducted at the end of the procedure. Also, the study cohort was subdivided into procedures conducted with 1 – 2 probes and 3 – 4 probes. Post-ablation AE rates were assessed by immediate and delayed (equal or more than one month), pneumothorax, hemothorax, pleural effusion, and whether intervention was required. Univariate and multivariate logistic regression analyses were used to compare differences in AE rates. Results Procedures with track cautery were 2.6 times less likely to exhibit pleural effusion (p=0.017). Procedures conducted with a higher number of probes were 3.8 times more likely to receive interventions (p<0.001), 1.6 times more likely to experience pneumothorax (p=0.037), and 2.1 times more likely to experience pleural effusion (p=0.003). History of lung surgery, increased number of probes, size of the probe, and absence of track cautery showed to be a significant predictor of AEs and need for interventions (p<0.05). Conclusions Track cauterization in lung cryoablation proves to reduce pleural effusion, but no difference in pneumothorax or delayed AEs. Decreasing the number of probes leads to a lower rate of AEs.