Efficacy of Radial Endobronchial Ultrasound (R-EBUS) guided transbronchial cryobiopsy for peripheral pulmonary lesions (PPL...s): A systematic review and meta-analysis
Background: Transbronchial lung cryobiopsy (TBLC) is frequently described for the diagnosis of diffuse parenchymal lung diseases (DPLD). A few studies have reported transbronchial cryobiopsy for the diagnosis of peripheral pulmonary lesions (PPL...s). We aimed to study the utility and safety of tran...
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| Format: | Article |
| Language: | English |
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Elsevier España
2023-01-01
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| Series: | Pulmonology |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S253104372030266X |
| _version_ | 1797961040265216000 |
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| author | P.B. Sryma S. Mittal N.K. Madan P. Tiwari V. Hadda A. Mohan R. Guleria K. Madan |
| author_facet | P.B. Sryma S. Mittal N.K. Madan P. Tiwari V. Hadda A. Mohan R. Guleria K. Madan |
| author_sort | P.B. Sryma |
| collection | DOAJ |
| description | Background: Transbronchial lung cryobiopsy (TBLC) is frequently described for the diagnosis of diffuse parenchymal lung diseases (DPLD). A few studies have reported transbronchial cryobiopsy for the diagnosis of peripheral pulmonary lesions (PPL...s). We aimed to study the utility and safety of transbronchial cryobiopsy for the diagnosis of PPL...s. Methods: We performed a systematic search of the PubMed and Embase databases to extract the relevant studies. We then performed a meta-analysis to calculate the diagnostic yields of transbronchial cryobiopsy and bronchoscopic forceps biopsy. Results: Following a systematic search, we identified nine relevant studies (300 patients undergoing cryobiopsy). All used Radial Endobronchial Ultrasound (R-EBUS) for PPL localization. The pooled diagnostic yield of transbronchial cryobiopsy was 77% (95% CI, 71%...84%) (I^2 = 38.72%, p = 0.11). The diagnostic yield of forceps biopsy was 72% (95% CI, 60%...83%) (I^2 = 78.56%, p < 0.01). The diagnostic yield of cryobiopsy and forceps biopsy was similar (RR 1.05, 95% CI 0.96...1.15), with a 5% risk difference for diagnostic yield (95% CI, ...6% to 15%). There was significant heterogeneity (I^2 = 57.2%, p = 0.017), and no significant publication bias. One severe bleeding and three pneumothoraxes requiring intercostal drain (ICD) placement (major complication rate 4/122, 1.8%) were reported with transbronchial cryobiopsy. Conclusions: R-EBUS guided transbronchial cryobiopsy is a safe and efficacious modality. The diagnostic yields of TBLC and forceps biopsy are similar. More extensive multicentre randomized trials are required for the further evaluation and standardization of transbronchial cryobiopsy for PPL...s. |
| first_indexed | 2024-04-11T00:53:08Z |
| format | Article |
| id | doaj.art-48541d649b8b49c6a0df6aa328cc5f38 |
| institution | Directory Open Access Journal |
| issn | 2531-0437 |
| language | English |
| last_indexed | 2024-04-11T00:53:08Z |
| publishDate | 2023-01-01 |
| publisher | Elsevier España |
| record_format | Article |
| series | Pulmonology |
| spelling | doaj.art-48541d649b8b49c6a0df6aa328cc5f382023-01-05T07:07:31ZengElsevier EspañaPulmonology2531-04372023-01-012915064Efficacy of Radial Endobronchial Ultrasound (R-EBUS) guided transbronchial cryobiopsy for peripheral pulmonary lesions (PPL...s): A systematic review and meta-analysisP.B. Sryma0S. Mittal1N.K. Madan2P. Tiwari3V. Hadda4A. Mohan5R. Guleria6K. Madan7Department of Pulmonary, Critical Care and Sleep Medicine, All India Institute of Medical Sciences (AIIMS), New Delhi 110029, IndiaDepartment of Pulmonary, Critical Care and Sleep Medicine, All India Institute of Medical Sciences (AIIMS), New Delhi 110029, IndiaDepartment of Pathology, VMMC and Safdarjung Hospital, New Delhi, IndiaDepartment of Pulmonary, Critical Care and Sleep Medicine, All India Institute of Medical Sciences (AIIMS), New Delhi 110029, IndiaDepartment of Pulmonary, Critical Care and Sleep Medicine, All India Institute of Medical Sciences (AIIMS), New Delhi 110029, IndiaDepartment of Pulmonary, Critical Care and Sleep Medicine, All India Institute of Medical Sciences (AIIMS), New Delhi 110029, IndiaDepartment of Pulmonary, Critical Care and Sleep Medicine, All India Institute of Medical Sciences (AIIMS), New Delhi 110029, IndiaDepartment of Pulmonary, Critical Care and Sleep Medicine, All India Institute of Medical Sciences (AIIMS), New Delhi 110029, India; Corresponding author.Background: Transbronchial lung cryobiopsy (TBLC) is frequently described for the diagnosis of diffuse parenchymal lung diseases (DPLD). A few studies have reported transbronchial cryobiopsy for the diagnosis of peripheral pulmonary lesions (PPL...s). We aimed to study the utility and safety of transbronchial cryobiopsy for the diagnosis of PPL...s. Methods: We performed a systematic search of the PubMed and Embase databases to extract the relevant studies. We then performed a meta-analysis to calculate the diagnostic yields of transbronchial cryobiopsy and bronchoscopic forceps biopsy. Results: Following a systematic search, we identified nine relevant studies (300 patients undergoing cryobiopsy). All used Radial Endobronchial Ultrasound (R-EBUS) for PPL localization. The pooled diagnostic yield of transbronchial cryobiopsy was 77% (95% CI, 71%...84%) (I^2 = 38.72%, p = 0.11). The diagnostic yield of forceps biopsy was 72% (95% CI, 60%...83%) (I^2 = 78.56%, p < 0.01). The diagnostic yield of cryobiopsy and forceps biopsy was similar (RR 1.05, 95% CI 0.96...1.15), with a 5% risk difference for diagnostic yield (95% CI, ...6% to 15%). There was significant heterogeneity (I^2 = 57.2%, p = 0.017), and no significant publication bias. One severe bleeding and three pneumothoraxes requiring intercostal drain (ICD) placement (major complication rate 4/122, 1.8%) were reported with transbronchial cryobiopsy. Conclusions: R-EBUS guided transbronchial cryobiopsy is a safe and efficacious modality. The diagnostic yields of TBLC and forceps biopsy are similar. More extensive multicentre randomized trials are required for the further evaluation and standardization of transbronchial cryobiopsy for PPL...s.http://www.sciencedirect.com/science/article/pii/S253104372030266XEndobronchial ultrasoundCryobiopsyLung cancerPeripheral pulmonary lesionLung noduleBiopsy |
| spellingShingle | P.B. Sryma S. Mittal N.K. Madan P. Tiwari V. Hadda A. Mohan R. Guleria K. Madan Efficacy of Radial Endobronchial Ultrasound (R-EBUS) guided transbronchial cryobiopsy for peripheral pulmonary lesions (PPL...s): A systematic review and meta-analysis Pulmonology Endobronchial ultrasound Cryobiopsy Lung cancer Peripheral pulmonary lesion Lung nodule Biopsy |
| title | Efficacy of Radial Endobronchial Ultrasound (R-EBUS) guided transbronchial cryobiopsy for peripheral pulmonary lesions (PPL...s): A systematic review and meta-analysis |
| title_full | Efficacy of Radial Endobronchial Ultrasound (R-EBUS) guided transbronchial cryobiopsy for peripheral pulmonary lesions (PPL...s): A systematic review and meta-analysis |
| title_fullStr | Efficacy of Radial Endobronchial Ultrasound (R-EBUS) guided transbronchial cryobiopsy for peripheral pulmonary lesions (PPL...s): A systematic review and meta-analysis |
| title_full_unstemmed | Efficacy of Radial Endobronchial Ultrasound (R-EBUS) guided transbronchial cryobiopsy for peripheral pulmonary lesions (PPL...s): A systematic review and meta-analysis |
| title_short | Efficacy of Radial Endobronchial Ultrasound (R-EBUS) guided transbronchial cryobiopsy for peripheral pulmonary lesions (PPL...s): A systematic review and meta-analysis |
| title_sort | efficacy of radial endobronchial ultrasound r ebus guided transbronchial cryobiopsy for peripheral pulmonary lesions ppl s a systematic review and meta analysis |
| topic | Endobronchial ultrasound Cryobiopsy Lung cancer Peripheral pulmonary lesion Lung nodule Biopsy |
| url | http://www.sciencedirect.com/science/article/pii/S253104372030266X |
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