Endobronchial ultrasound plus fluoroscopy-guided biopsy compared to fluoroscopy-guided transbronchial biopsy for obtaining samples of peripheral pulmonary lesions: A systematic review and meta-analysis.

Authors:
Jian Ye
Jian Ye
St. Paul's Hospital
Canada
Ruifeng Zhang
Ruifeng Zhang
Ruijin Hospital
China
Shenglin Ma
Shenglin Ma
Zhejiang Cancer Hospital
China
Limin Wang
Limin Wang
Institute of Microbiology
China
Weizhong Jin
Weizhong Jin
Fudan University
China

Ann Thorac Med 2017 Apr-Jun;12(2):114-120

Department of Pulmonary Medicine, Hangzhou First People's Hospital, Nanjing Medical University, Hangzhou, China.

Background: We report a meta-analysis of recent studies comparing the diagnostic yields of endobronchial ultrasonography plus fluoroscopically-guided transbronchial biopsy (EBUS + TBB) with that of conventional fluoroscopically-guided TBB for peripheral pulmonary lesions (PPLs).

Methods: We searched Medline, the Cochrane Library, PubMed, and Google Scholar through 31 March 2013 using the keywords: lung neoplasm, pulmonary lesions, diagnosis, endobronchial ultrasound, fluoroscopy, and fluoroscopic.

Results: Four studies were included in the study with a total of 461 patients, 222 in the EBUS + TBB group and 239 in the TBB only group. The meta-analysis revealed that the group with EBUS + TBB was more favored in terms of positive diagnostic yield than the group diagnosed with only conventional TBB (odds ratio [OR] = 2.211, 95% confidence interval [CI] = 1.422-3.438, < 0.001). Subgroup analysis based on lesion size found that smaller PPLs had higher accuracy (OR = 4.502, 95% CI = 2.002-10.126, < 0.001) than PPLs of large size (OR = 1.849, 95% CI = 1.033-3.311, = 0.039).

Conclusion: Obtaining TBB samples for histopathological diagnosis is enhanced by the addition of EBUS to conventional fluoroscopic guidance; this is, especially important for patients with small peripheral lung lesions who benefit greatly from early diagnosis.

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http://dx.doi.org/10.4103/atm.ATM_298_16DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5399685PMC
May 2017
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