[PMID]: | 29357388 |
[Au] Autor: | Han Y; Kim HJ; Kong KA; Kim SJ; Lee SH; Ryu YJ; Lee JH; Kim Y; Shim SS; Chang JH |
[Ad] Endereço: | Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, School of Medicine, Ewha Womans University, Seoul, Republic of Korea. |
[Ti] Título: | 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. |
[So] Source: | PLoS One;13(1):e0191590, 2018. |
[Is] ISSN: | 1932-6203 |
[Cp] País de publicação: | United States |
[La] Idioma: | eng |
[Ab] Resumo: | BACKGROUND: Advances in bronchoscopy and CT-guided lung biopsy have improved the evaluation of small pulmonary lesions (PLs), leading to an increase in preoperative histological diagnosis. We aimed to evaluate the efficacy and safety of transbronchial lung biopsy using radial endobronchial ultrasound and virtual bronchoscopic navigation (TBLB-rEBUS&VBN) and CT-guided transthoracic needle biopsy (CT-TNB) for tissue diagnosis of small PLs. METHODS: A systematic search was performed in five electronic databases, including MEDLINE, EMBASE, Cochrane Library Central Register of Controlled Trials, Web of Science, and Scopus, for relevant studies in May 2016; the selected articles were assessed using meta-analysis. The articles were limited to those published after 2000 that studied small PLs ≤ 3 cm in diameter. RESULTS: From 7345 records, 9 articles on the bronchoscopic (BR) approach and 15 articles on the percutaneous (PC) approach were selected. The pooled diagnostic yield was 75% (95% confidence interval [CI], 69-80) using the BR approach and 93% (95% CI, 90-96) using the PC approach. For PLs ≤ 2 cm, the PC approach (pooled diagnostic yield: 92%, 95% CI: 88-95) was superior to the BR approach (66%, 95% CI: 55-76). However, for PLs > 2 cm but ≤ 3 cm, the diagnostic yield using the BR approach was improved to 81% (95% CI, 75-85). Complications of pneumothorax and hemorrhage were rare with the BR approach but common with the PC approach. CONCLUSIONS: CT-TNB was superior to TBLB-rEBUS&VBN for the evaluation of small PLs. However, for lesions greater than 2 cm, the BR approach may be considered considering its diagnostic yield of over 80% and the low risk of procedure-related complications. |
[Mh] Termos MeSH primário: |
Pneumopatias/diagnóstico Neoplasias Pulmonares/diagnóstico
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[Mh] Termos MeSH secundário: |
Biópsia por Agulha/efeitos adversos Biópsia por Agulha/métodos Broncoscopia/efeitos adversos Broncoscopia/métodos Endossonografia/efeitos adversos Endossonografia/métodos Hemoptise/etiologia Hemorragia/etiologia Seres Humanos Biópsia Guiada por Imagem/efeitos adversos Biópsia Guiada por Imagem/métodos Pneumopatias/diagnóstico por imagem Pneumopatias/patologia Neoplasias Pulmonares/diagnóstico por imagem Neoplasias Pulmonares/patologia Pneumotórax/etiologia Tomografia Computadorizada por Raios X/métodos Interface Usuário-Computador
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[Pt] Tipo de publicação: | JOURNAL ARTICLE; META-ANALYSIS; REVIEW |
[Em] Mês de entrada: | 1803 |
[Cu] Atualização por classe: | 180302 |
[Lr] Data última revisão:
| 180302 |
[Sb] Subgrupo de revista: | IM |
[Da] Data de entrada para processamento: | 180123 |
[St] Status: | MEDLINE |
[do] DOI: | 10.1371/journal.pone.0191590 |
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