Lung Biopsy Information for Patients Radiology Service
Contents What is a lung biopsy? 3 Why do I need a lung biopsy? 3 Facilities available 5 Travel to the hospital 6 What happens during the procedure? 7 How do I get the results? 8 Are all biopsies successful? 8 Consent for the procedure 9 What happens after the procedure? 10 Contact details 12 2 Date issued September 2011 / Review date September 2013 / Rad B PIB-01 / LUNG BIOPSY NO 2
What is a lung biopsy? A biopsy is a way of taking a small piece of lung tissue out of your body, using only a tiny cut in the skin and a thin needle. The biopsy will then be examined under a microscope by a pathologist (an expert in making a diagnosis from tissue samples). This method of taking a biopsy is sometimes called a percutaneous biopsy Why do I need a lung biopsy? Previous X-rays or scans have shown an area of your lung may be abnormal. From the X-rays and scans it is not always possible to say exactly what the abnormality is. The simplest way of finding out is by taking a tiny piece of it away for a pathologist to examine. Can I take my normal medicines? If you are on medication from your doctor, please continue to take it as normal with the exception of medication that thins the blood. If you are taking medication that thins the blood please contact the Radiology Department for advice. These drugs include WARFARIN and CLOPIDOGREL (Plavix). 3 Booklet Name Health service
Do not drive yourself home after the procedure. Car Parking Parking is available in the Underground Car Park beneath the Regional Hospital Building (Level 1). Parking is charged and is paid at the machines in the Lift access foyers in the Car park Level 1. Relatives and escorts You should bring a support person, friend or relative to accompany you to and from the Radiology Department when you have your examination although they may not always be allowed into the examination room. This may be useful if you have any special needs. 4
Facilities available Refreshments Refreshments including hot and cold drinks are available in the hospital. Please ask a member of staff for directions. Shops The hospital contains a shop in the main foyer that sells magazines, newspapers, sweets and drinks. Please ask a member of staff for directions. How was it for you? If you wish to make any comments or suggestions regarding your visit to the Radiology department. Please fill in a feedback form or speak to a member of staff. Feedback forms are located in all waiting areas within the department. We review our information leaflets on a regular basis. If you have any comments about how we can improve these leaflets please speak to a member of staff. 5 Lung Biopsy Radiology Service
Travel to the Hospital Buses A number of bus services (including bus routes 1, 3, 10, 11, 18, 22, 23, 42, 43/44) pass by the main entrance of Wellington Hospital in Riddiford Street, Newtown. Details of times and bus numbers are available by calling 0800 801 700. Taxis Taxis are available from the front of the hospital on Riddiford Street. A free shuttle for patients also runs between Wellington and Kenepuru hospitals. To book, please call 04 385 5999 ext 7088. Information for patients with diabetes If you are diabetic it is important to have a normal breakfast. You may need to adjust your medication. Please contact your diabetes specialist nurse for advice. If your diabetes is managed by your GP or Practice nurse please contact your surgery. How do I prepare for the procedure? You will have had some blood tests performed before hand to make sure that you do not have an increased risk of bleeding. You will be asked not to eat for four hours before your biopsy, though you are allowed to drink some water. Occasionally you may need to stay overnight in hospital after the biopsy. If you live alone or more than 30 minutes 6
from the hospital you will probably. Please contact us on 04 3855999 for more information. We advise everyone to prepare an overnight bag and bring this with you just in case Before the biopsy a needle may be put into a vein in your arm, either on the ward or when you arrive for your biopsy. This is so that you may be given medication if necessary. You will also be asked to put on a hospital gown. What happens during the procedure? The biopsy will take place in the Radiology Department in either a CT scanner or Ultrasound room.you will be asked to lie on the CT or Ultrasound scanning table in the position that the Radiologist has decided is most suitable. It is important that you stay very still in this position until the procedure is over. If you are uncomfortable please let the doctor know. Everything will be kept sterile and the Radiologist will wear sterile gloves. Your skin will be cleaned with antiseptic and you will have some of your body covered with a sterile sheet. An Ultrasound machine or the CT scanner will be used to decide on the most suitable place for inserting the biopsy needle. The Radiologist will look at the images while carrying out the biopsy to make sure that the needle is placed as accurately as possible. Your skin and the surrounding tissue will then be numbed with local anaesthetic and the biopsy needle will be inserted into the abnormal tissue. The first part of the procedure when the equipment is being 7 Lung Biopsy Radiology Service
prepared may seem to take a while but doing the biopsy itself does not take very long at all.the biopsy needle often makes a small clicking noise which should not alarm you. The Radiologist will need to take two to three samples. How do I get the results? Your doctor (who referred you for the biopsy) is responsible for informing you about the results of your biopsy. The results take at least 2 working days. You may receive an outpatient appointment or be telephoned with the results. Please discuss with the ward nursing staff before you go home to make sure this has been arranged. Are all biopsies successful? Not all biopsies are successful. This may be because the piece of tissue has been taken from normal tissue rather than the abnormal tissue. Alternatively, the amount of abnormal tissue obtained may not be enough for the pathologist to make a definite diagnosis. The Radiologist doing your biopsy may be able to give you some idea as to the possibility that a satisfactory sample has been obtained. Lung biopsies get an answer in 9 out of 10 patients. Occasionally the procedure has to be repeated or another test performed. If you require any additional information about your biopsy, please contact the Radiology Department and a Radiologist will be able to discuss any queries you may have. 8
Consent for the Procedure The clinician who referred you should have discussed the reasons for needing a lung biopsy.you should make sure that you understand these reasons, the procedure itself, any risks involved and the success rates. The Consultant or the Radiologist (a specialised X-ray doctor) who will be performing the biopsy, will ask you to sign a form called consent. When you sign this it means you have agreed to have the biopsy done and that you understand why it is needed. You will have a copy to take away. If after discussion with your hospital doctor or Radiologist you do not want the procedure carried out, then you can decide against it. If you feel during the procedure that you do not want it to continue we will explain the implications of not doing so, to help you fully decide. If the Radiologist feels that your condition has changed or that your symptoms do not indicate such a procedure is necessary then he/she will explain this to you, communicate with the referring clinician and ask that you return to your referring clinician for review. At all times the Radiologist and referring clinician will be acting in your best interests. Will it hurt? You may feel some pain or discomfort. When the local anaesthetic is injected, it will sting to start with, but this soon wears off, and the skin and deeper tissues should then feel numb. Later, you may be aware of a pushing sensation as the 9 Lung Biopsy Radiology Service
needle is positioned, but this is generally done so quickly that it does not cause much discomfort. If the procedure does become painful you should tell the person performing the biopsy and they may give you more local anaesthetic. What happens after the procedure? You will be taken back to the Interventional Recovery Ward (IRW) or your ward if you are an in-patient. Nurses will check your pulse, blood pressure and temperature, to make sure that there are no problems. You will have to stay in bed for 4 to 6 hours after the procedure until you have recovered. You will almost certainly have a chest X-ray performed before you go home. You will not be sent home until it is considered safe to do so. Do not drive yourself home after the procedure What if I need to talk to someone after the procedure? If you have any problems after the procedure please speak to the staff on the ward. If you have any problems relating to your biopsy procedure once you have left hospital, please contact your GP for advice. You can also contact the lung nurse specialist. 10
Are there any risks or complications? As with any procedure or operation complications are possible. We have included the most common risks and complications in this leaflet. The possibility of these complications occurring will vary for each patient and the possibility of these complications happening to you will be discussed with you before you sign the consent form. It is possible that air may get into the space around the lung. This is also know as a collapsed lung or a pneumothorax. If this occurs then the air may need to be drained either with a needle or with a small tube put in through the skin. This is only needed in less than 1 in 20 patients. Any biopsy carries a small risk of bleeding. If you cough up some blood after the procedure please do not be alarmed as this will stop shortly. There may be soreness around the biopsy site and some bruising. At all times during and after the procedure the staff will be monitoring your responses to this treatment in order to minimize the effects of any complications. Despite these possible complications, a lung biopsy is normally very safe and can save you from having a bigger procedure which would have higher risks. 11 Lung Biopsy Radiology Service
Who do I contact for more information? The best source of information is your own doctor. Alternatively, if you need additional advice you may contact us on the information listed below Need help? Call us on: 04 806 0273 (Interventional Radiology Ward) Fax us on: 04 385 5990 Email: joyti.pran@ccdhb.org.nz or radiology.admin@ccdhb.org.nz Or visit www.ccdhb.org.nz Our normal hours are 7:30am - 8:00pm Monday to Friday For after hours emergencies, contact your local After Hours Cente or Local Hospital Emergency Department.