Diagnostic yield and safety of transbronchial lung cryobiopsy and surgical lung biopsy in interstitial lung diseases: a systematic review and meta-analysis
Introduction: Transbronchial lung cryobiopsy (TBLC) is increasingly being used as an alternative to video-assisted thoracoscopic surgery (VATS) biopsy to establish the histopathologic pattern in interstitial lung disease (ILD). Methods: A systematic literature search of the PubMed and Embase databas...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
European Respiratory Society
2022-10-01
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| Series: | European Respiratory Review |
| Online Access: | http://err.ersjournals.com/content/31/166/210280.full |
| _version_ | 1797961071011561472 |
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| author | Inês Rodrigues Ricardo Estêvão Gomes Lígia Maria Coutinho Maria Teresa Rego Firmino Machado António Morais Helder Novais Bastos |
| author_facet | Inês Rodrigues Ricardo Estêvão Gomes Lígia Maria Coutinho Maria Teresa Rego Firmino Machado António Morais Helder Novais Bastos |
| author_sort | Inês Rodrigues |
| collection | DOAJ |
| description | Introduction:
Transbronchial lung cryobiopsy (TBLC) is increasingly being used as an alternative to video-assisted thoracoscopic surgery (VATS) biopsy to establish the histopathologic pattern in interstitial lung disease (ILD).
Methods:
A systematic literature search of the PubMed and Embase databases, from October 2010 to October 2020, was conducted to identify studies that reported on diagnostic yield or safety of VATS or TBLC in the diagnosis of ILD.
Results:
43 studies were included. 23 evaluated the diagnostic yield of TBLC after multidisciplinary discussion, with a pooled diagnostic yield of 76.8% (95% confidence interval (CI) 70.6–82.1), rising to 80.7% in centres that performed ≥70 TBLC. 10 studies assessed the use of VATS and the pooled diagnostic yield was 93.5% (95% CI 88.3–96.5). In TBLC, pooled incidences of complications were 9.9% (95% CI 6.8–14.3) for significant bleeding (6.9% for centres with ≥70 TBLC), 5.6% (95% CI 3.8–8.2) for pneumothorax treated with a chest tube and 1.4% (95% CI 0.9–2.2) for acute exacerbation of ILD after TBLC. The mortality rates were 0.6% and 1.7% for TBLC and VATS, respectively.
Conclusions:
TBLC has a fairly good diagnostic yield, an acceptable safety profile and a lower mortality rate than VATS. The best results are obtained from more experienced centres. |
| first_indexed | 2024-04-11T00:53:38Z |
| format | Article |
| id | doaj.art-b74c6267ca8640c2b479d235ae5dc634 |
| institution | Directory Open Access Journal |
| issn | 0905-9180 1600-0617 |
| language | English |
| last_indexed | 2024-04-11T00:53:38Z |
| publishDate | 2022-10-01 |
| publisher | European Respiratory Society |
| record_format | Article |
| series | European Respiratory Review |
| spelling | doaj.art-b74c6267ca8640c2b479d235ae5dc6342023-01-05T07:48:22ZengEuropean Respiratory SocietyEuropean Respiratory Review0905-91801600-06172022-10-013116610.1183/16000617.0280-20210280-2021Diagnostic yield and safety of transbronchial lung cryobiopsy and surgical lung biopsy in interstitial lung diseases: a systematic review and meta-analysisInês Rodrigues0Ricardo Estêvão Gomes1Lígia Maria Coutinho2Maria Teresa Rego3Firmino Machado4António Morais5Helder Novais Bastos6 Pulmonology Dept, Centro Hospitalar de Trás-os-Montes e Alto Douro, Vila Real, Portugal Pulmonology Dept, Hospital Garcia de Orta, Almada, Portugal Escola de Medicina, University of Minho, Braga, Portugal Escola de Medicina, University of Minho, Braga, Portugal Centro Hospitalar Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal Faculdade de Medicina, University of Porto, Porto, Portugal Faculdade de Medicina, University of Porto, Porto, Portugal Introduction: Transbronchial lung cryobiopsy (TBLC) is increasingly being used as an alternative to video-assisted thoracoscopic surgery (VATS) biopsy to establish the histopathologic pattern in interstitial lung disease (ILD). Methods: A systematic literature search of the PubMed and Embase databases, from October 2010 to October 2020, was conducted to identify studies that reported on diagnostic yield or safety of VATS or TBLC in the diagnosis of ILD. Results: 43 studies were included. 23 evaluated the diagnostic yield of TBLC after multidisciplinary discussion, with a pooled diagnostic yield of 76.8% (95% confidence interval (CI) 70.6–82.1), rising to 80.7% in centres that performed ≥70 TBLC. 10 studies assessed the use of VATS and the pooled diagnostic yield was 93.5% (95% CI 88.3–96.5). In TBLC, pooled incidences of complications were 9.9% (95% CI 6.8–14.3) for significant bleeding (6.9% for centres with ≥70 TBLC), 5.6% (95% CI 3.8–8.2) for pneumothorax treated with a chest tube and 1.4% (95% CI 0.9–2.2) for acute exacerbation of ILD after TBLC. The mortality rates were 0.6% and 1.7% for TBLC and VATS, respectively. Conclusions: TBLC has a fairly good diagnostic yield, an acceptable safety profile and a lower mortality rate than VATS. The best results are obtained from more experienced centres.http://err.ersjournals.com/content/31/166/210280.full |
| spellingShingle | Inês Rodrigues Ricardo Estêvão Gomes Lígia Maria Coutinho Maria Teresa Rego Firmino Machado António Morais Helder Novais Bastos Diagnostic yield and safety of transbronchial lung cryobiopsy and surgical lung biopsy in interstitial lung diseases: a systematic review and meta-analysis European Respiratory Review |
| title | Diagnostic yield and safety of transbronchial lung cryobiopsy and surgical lung biopsy in interstitial lung diseases: a systematic review and meta-analysis |
| title_full | Diagnostic yield and safety of transbronchial lung cryobiopsy and surgical lung biopsy in interstitial lung diseases: a systematic review and meta-analysis |
| title_fullStr | Diagnostic yield and safety of transbronchial lung cryobiopsy and surgical lung biopsy in interstitial lung diseases: a systematic review and meta-analysis |
| title_full_unstemmed | Diagnostic yield and safety of transbronchial lung cryobiopsy and surgical lung biopsy in interstitial lung diseases: a systematic review and meta-analysis |
| title_short | Diagnostic yield and safety of transbronchial lung cryobiopsy and surgical lung biopsy in interstitial lung diseases: a systematic review and meta-analysis |
| title_sort | diagnostic yield and safety of transbronchial lung cryobiopsy and surgical lung biopsy in interstitial lung diseases a systematic review and meta analysis |
| url | http://err.ersjournals.com/content/31/166/210280.full |
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