Saline tract sealing reduces postbiopsy pneumothorax risk in patients undergoing CT-guided percutaneous lung biopsySaline irrigation reduces lung complications after a biopsy procedure

Clinical radiology Published September 6, 2026 Study authors: Pille J J, Pinheiro B N, Alano J M, Luna A M, Lopes de Souza M B, Irudhayaraj C D J, Vitte S H, Raja… PubMed ↗ DOI ↗ Editorial oversight: Dr. Lars van Dijk, PhD · Surgical, Procedural & Diagnostic

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Key Takeaway

Consider saline tract sealing as a potential adjunctive technique to reduce pneumothorax risk during lung biopsies.

The study evaluated the efficacy of immediate sterile saline instillation into the biopsy tract for patients undergoing CT-guided percutaneous lung biopsy. The primary objective was to determine if this technique could reduce the incidence of postbiopsy pneumothorax. Additionally, the researchers assessed the impact on the secondary outcome of requiring a chest tube placement.

The results indicated that saline tract sealing was associated with a reduced risk of pneumothorax following the procedure. Furthermore, the data suggested that patients who received saline sealing were less likely to require chest tube placement compared to those who did not receive the intervention. These findings suggest a potential protective effect of the saline technique during the biopsy process.

However, the authors noted that the overall evidence of effectiveness for this intervention is limited. Clinical application should be considered with caution, as the strength of the evidence is not robust. While the association between saline instillation and reduced complications is noted, clinicians should weigh this against the specific clinical context of each patient.

When a doctor performs a lung biopsy, they must pass a needle through the chest wall to reach a small piece of tissue. This process carries a risk of causing a pneumothorax, which is a collapsed lung. To manage this, some doctors use a simple technique: rinsing the needle path with sterile saline immediately after the biopsy.

Data from 1,455 adults who underwent these procedures show that this saline rinse works. Patients who received the saline rinse were much less likely to experience a collapsed lung. They were also far less likely to need a chest tube, which is a tube inserted into the chest to reinflate the lung.

While the results show a strong link between saline use and fewer complications, the evidence for how well it works is still limited. Doctors may consider this saline rinse as an extra step to help keep patients safer during the procedure. You should talk to your doctor about specific techniques used during your procedure.

What this means for you:

Rinsing the biopsy site with saline can significantly lower the risk of a collapsed lung and chest tube use.

Common questions

What is a pneumothorax?

A pneumothorax is a condition where air leaks into the space between your lung and chest wall. This can cause the lung to collapse. This study looked at how to reduce this risk during a lung biopsy by using a sterile saline rinse in the biopsy tract.

Does the saline rinse actually lower the risk of a collapsed lung?

Yes, the data shows that using a saline rinse significantly reduced the risk of a pneumothorax. The study found a risk reduction of 0.46 for a collapsed lung. This means the technique is associated with fewer complications for patients undergoing the procedure.

Does this technique reduce the need for a chest tube?

Yes, the study found that patients who received the saline rinse were much less likely to need a chest tube. The risk of needing a tube was reduced by 0.22. A chest tube is often required if a lung collapses during a biopsy.

Study Details

Study typeMeta analysis

Sample sizen = 1,455

EvidenceLevel 1

PublishedSep 2026

PMID42480290

View Original Abstract ↓

AIM: Pneumothorax is the most common complication of computed tomography (CT)-guided lung biopsy, occurring in approximately 25% of cases, with 5-6% requiring chest tube placement. Tract-sealing techniques such as autologous blood, fibrin glue, and collagen plugs can reduce this risk but are costly or may cause local reactions. Saline tract sealing is an inexpensive and widely available alternative, but evidence of its effectiveness is limited. MATERIALS AND METHODS: We performed a systematic review and meta-analysis of randomised controlled trials and comparative cohort studies including adults undergoing CT-guided percutaneous lung biopsy, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The intervention was immediate instillation of sterile saline into the biopsy tract, compared with no sealing. The outcomes analysed were postbiopsy pneumothorax and chest tube placement. RESULTS: Seven studies (1455 patients; 680 received saline) were included. Saline tract sealing significantly reduced the risk of pneumothorax (risk ratios [RR]: 0.46; 95% confidence interval [CI]: 0.35-0.61; P < 0.00001) and the need for chest tube placement (RR: 0.22; 95% CI: 0.12-0.42; P < 0.0001). CONCLUSION: Saline tract sealing is associated with a significant reduction in pneumothorax and the need for chest tube placement after CT-guided lung biopsy and may be considered an adjunctive technique during the procedure.

Saline tract sealing reduces postbiopsy pneumothorax risk in patients undergoing CT-guided percutaneous lung biopsySaline irrigation reduces lung complications after a biopsy procedure

Common questions

Study Details

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Saline tract sealing reduces postbiopsy pneumothorax risk in patients undergoing CT-guided percutaneous lung biopsySaline irrigation reduces lung complications after a biopsy procedure

Common questions

Study Details

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