Diagnosis of small pulmonary lesions by transbronchial lung biopsy with radial endobronchial ultrasound and virtual bronchoscopic navigation versus CT-guided transthoracic needle biopsy: A systematic review and meta-analysis

摘要: Background Advances in bronchoscopy and CT-guided lung biopsy have improved the evaluation of small pulmonary lesions (PLs), leading to an increase preoperative histological diagnosis. We aimed evaluate efficacy safety transbronchial using radial endobronchial ultrasound virtual bronchoscopic navigation (TBLB-rEBUS&VBN) transthoracic needle (CT-TNB) for tissue diagnosis PLs. Methods A systematic search was performed five electronic databases, including MEDLINE, EMBASE, Cochrane Library Central Register Controlled Trials, Web Science, Scopus, relevant studies May 2016; selected articles were assessed meta-analysis. The limited those published after 2000 that studied PLs ≤ 3 cm diameter. Results From 7345 records, 9 on (BR) approach 15 percutaneous (PC) selected. pooled diagnostic yield 75% (95% confidence interval [CI], 69–80) BR 93% CI, 90–96) PC approach. For 2 cm, (pooled yield: 92%, 95% CI: 88–95) superior (66%, 55–76). However, > but 81% 75–85). Complications pneumothorax hemorrhage rare with common approach. Conclusions CT-TNB TBLB-rEBUS&VBN PLs. greater than may be considered considering its over 80% low risk procedure-related complications.