Dataset Information

Ultrathin Bronchoscopy for the Diagnosis of Peripheral Pulmonary Lesions: A Meta-Analysis.

ABSTRACT:

Background

Ultrathin bronchoscopy (external diameter, ≤3.5 mm) is useful for the diagnosis of peripheral pulmonary lesions because of its good accessibility.

Objectives

We performed a meta-analysis to investigate the diagnostic yield of ultrathin bronchoscopy for peripheral pulmonary lesions.

Methods

We performed a systematic search of MEDLINE and EMBASE (from inception to May 2021), and meta-analysis was performed using R software. The diagnostic yield was evaluated by dividing the number of successful diagnoses by the total number of lesions, and subgroup analysis was performed to identify related factors.

Results

Nineteen studies with a total of 1,977 peripheral pulmonary lesions were included. The pooled diagnostic yield of ultrathin bronchoscopy was 0.65 (95% confidence interval, 0.60-0.70). Significant heterogeneity was observed among studies (χ2, 87.75; p < 0.01; I2, 79.5%). In a subgroup analysis, ultrathin bronchoscopy with 1.2 mm channel size showed a diagnostic yield of 0.61 (95% confidence interval, 0.53-0.68), whereas ultrathin bronchoscopy with 1.7 mm channel size showed 0.70 (95% confidence interval, 0.66-0.74) (χ2, 5.35; p = 0.02). In addition, there was a significant difference in diagnostic yield based on lesion size, histologic diagnosis (malignant vs. benign), bronchus sign, and lesion location from the hilum, whereas no significant difference was found based on lobar location. The overall complication rate of ultrathin bronchoscopy was 2.7% (pneumothorax, 1.1%).

Conclusions

Ultrathin bronchoscopy is an excellent tool for peripheral pulmonary lesion diagnosis with a low complication rate. The diagnostic yield of ultrathin bronchoscopy was significantly higher with larger channel size, which might be attributed to the availability of radial endobronchial ultrasound.

SUBMITTER: Kim SH

PROVIDER: S-EPMC9843548 | biostudies-literature | 2023

REPOSITORIES: biostudies-literature

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Publications

Ultrathin Bronchoscopy for the Diagnosis of Peripheral Pulmonary Lesions: A Meta-Analysis.

Kim Soo Han SH Kim Jinmi J Pak Kyoungjune K Eom Jung Seop JS

Respiration; international review of thoracic diseases 20221122 1

<h4>Background</h4>Ultrathin bronchoscopy (external diameter, ≤3.5 mm) is useful for the diagnosis of peripheral pulmonary lesions because of its good accessibility.<h4>Objectives</h4>We performed a meta-analysis to investigate the diagnostic yield of ultrathin bronchoscopy for peripheral pulmonary lesions.<h4>Methods</h4>We performed a systematic search of MEDLINE and EMBASE (from inception to May 2021), and meta-analysis was performed using R software. The diagnostic yield was evaluated by div ...[more]

PMID: 36412624

Similar Datasets

Project description:BackgroundCone-beam computed tomography (CBCT)-guided bronchoscopy is increasingly utilized for diagnosing peripheral pulmonary lesions (PPLs). We carried out the meta-analysis for assessing the efficacy and safety of CBCT-guided bronchoscopy for PPLs.MethodsAn extensive search in several databases was conducted to identify relevant articles. We evaluated the quality of studies with the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool. The pooled diagnostic yield (DY) and adverse event rate with the 95% confidence interval (CI) were computed. Subgroup analyses were performed according to additional use of navigation, use of radial endobronchial ultrasound (rEBUS), use of fixed or mobile CBCT, whether computed tomography (CT) spin was performed before biopsy to affirm tool-in-lesion, use of rapid onsite cytologic examination (ROSE), strictness of the definition of DY, and study design. Further analysis was performed to explore the association between odds of diagnosis with CBCT guided bronchoscopy and PPLs characteristics (>20 vs. ≤20 mm, non-upper lobe vs. upper lobe, with bronchus sign vs. without bronchus sign, and solid vs. non-solid) as well as sampling methods (forceps vs. fine needle aspiration, forceps vs. cryoprobe sampling). The pooled odds ratio (OR) and 95% CI were calculated. The significance level was set at 0.05. All analyses were performed by using meta package in R version 4.3.2.ResultsWe included 23 studies involving 1,769 patients and 1,863 PPLs in the meta-analysis. The overall pooled DY of CBCT-guided bronchoscopy was 80.2% (95% CI: 76.0-84.1%). Subgroup analysis showed that the DY was highest when CBCT was used with robotic-assisted navigation bronchoscopy (pooled DY 87.5%; 95% CI: 81.5-92.4%), the DY was 78.9% (95% CI: 70.8-85.9%) when CBCT was used alone without other navigation techniques. Lesion size >20 mm, presence of bronchus sign and solid lesions were associated with significant increase in the odds of diagnosis with CBCT-guided bronchoscopy. Pooled adverse event rate was 2.3% (95% CI: 1.2-3.6%).ConclusionsCBCT-guided bronchoscopy is a safe technique with high DY in diagnosing PPLs.

Dataset Information

Ultrathin Bronchoscopy for the Diagnosis of Peripheral Pulmonary Lesions: A Meta-Analysis.

Background

Objectives

Methods

Results

Conclusions

Publications

Ultrathin Bronchoscopy for the Diagnosis of Peripheral Pulmonary Lesions: A Meta-Analysis.

Similar Datasets

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