Safety of Transbronchial Biopsies in Patients with Pulmonary Hypertension: Systematic Review and Meta-Analysis

Ali, Muhammad; Sethi, Jaskaran; Ghori, Uzair; Cardenas, José De; Wayne, Max T; Maldonado, Fabien

doi:10.1513/annalsats.202211-965oc

Cited by 4 publications

(4 citation statements)

References 39 publications

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“…The pooled diagnostic yield in our meta‐analysis is comparable to previously published studies that reported pooled diagnostic yields of 76.5%–84.3% for RAB 11,14,41 . Despite the comparable results, in previous meta‐analyses, the diagnostic yields in the included studies were defined differently.…”

Section: Discussionsupporting

confidence: 73%

“…The pooled diagnostic yield in our meta-analysis is comparable to previously published studies that reported pooled diagnostic yields of 76.5%-84.3% for RAB. 11,14,41 Despite the comparable results, in previous meta-analyses, the diagnostic yields in the included studies were defined differently. Instead of directly synthesizing the diagnostic yields reported in individual studies, we extracted the actual results of RAB and reconstructed the diagnostic yields according to a uniform definition.…”

Section: Discussionmentioning

confidence: 96%

“…10 To date, only one meta-analysis has specifically evaluated the diagnostic performance of RAB. 11 Nevertheless, the diagnostic yields in the included studies were defined differently and some new studies have been published. In this meta-analysis, both old and recent studies were included.…”

Section: Introductionmentioning

confidence: 99%

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Robotic‐assisted bronchoscopy for the diagnosis of peripheral pulmonary lesions: A systematic review and meta‐analysis

Zhang,

Xie,

et al. 2024

Thoracic Cancer

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Robotic‐assisted bronchoscopy (RAB) is a newly developed bronchoscopic technique for the diagnosis of peripheral pulmonary lesions (PPLs). The objective of this meta‐analysis was to analyze the diagnostic yield and safety of RAB in patients with PPLs. Five databases (PubMed, Embase, Web of Science, CENTRAL, and ClinicalTrials.gov) were searched from inception to April 2023. Two independent investigators screened retrieved articles, extracted data, and assessed the study quality. The pooled diagnostic yield and complication rate were estimated. Subgroup analysis was used to explore potential sources of heterogeneity. Publication bias was assessed using funnel plots and the Egger test. Sensitivity analysis was also conducted to assess the robustness of the synthesized results. A total of 725 lesions from 10 studies were included in this meta‐analysis. No publication bias was found. Overall, RAB had a pooled diagnostic yield of 80.4% (95% CI: 75.7%–85.1%). Lesion size of >30 mm, presence of a bronchus sign, and a concentric radial endobronchial ultrasound view were associated with a statistically significantly higher diagnostic yield. Heterogeneity exploration showed that studies using cryoprobes reported better yields than those without cryoprobes (90.0%, 95% CI: 83.2%–94.7% vs. 79.0%, 95% CI: 75.8%–82.2%, p < 0.01). The pooled complication rate was 3.0% (95% CI: 1.6%–4.4%). In conclusion, RAB is an effective and safe technique for PPLs diagnosis. Further high‐quality prospective studies still need to be conducted.

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Section: Discussionsupporting

confidence: 73%

Section: Discussionmentioning

confidence: 96%

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Robotic‐assisted bronchoscopy for the diagnosis of peripheral pulmonary lesions: A systematic review and meta‐analysis

Zhang,

Xie,

et al. 2024

Thoracic Cancer

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“…A meta-analysis of RAB showed that lesion size of > 2 cm, presence of bronchus sign, and concentric rEBUS view were associated with high diagnostic yield. 22 However, there was a high heterogeneity of the studies included in the meta-analysis and it included a great deal of lesions > 3 cm. Therefore, these factors affecting the diagnostic yield of SS-RAB should be explored in more studies with a larger sample size.…”

Section: Discussionmentioning

confidence: 99%

Shape-sensing Robotic-assisted Bronchoscopy (SS-RAB) in Sampling Peripheral Pulmonary Nodules

Xie,

Zhang,

et al. 2024

Journal of Bronchology &Amp; Interventional Pulmonology

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Background: The ION system is a shape-sensing robotic-assisted bronchoscopy (SS-RAB) platform developed to biopsy peripheral pulmonary nodules (PPNs). There is a lack of data describing the use of this system in the Chinese population. The study aimed to assess the feasibility and safety of using SS-RAB to diagnose PPNs across multiple centers within China. Methods: This prospective, multicenter study used SS-RAB in consecutive patients with solid or sub-solid PPNs 8 to 30 mm in largest diameter. Primary endpoints were diagnostic yield and the rates of procedure- or device-related complications. Radial endobronchial ultrasound (rEBUS) was to confirm lesion localization, followed by sampling, using the Flexision biopsy needle, biopsy forceps, and cytology brush. Subjects with nonmalignant index biopsy results were followed up to 6 months. Results: A total of 90 PPNs were biopsied from 90 subjects across 3 centers using SS-RAB. The median nodule size was 19.4 mm (IQR: 19.3, 24.6) in the largest dimension. In all (100%) cases, the catheter successfully reached the target nodule with tissue samples obtained. The diagnostic yield was 87.8% with a sensitivity for malignancy of 87.7% (71/81). In a univariate analysis, nodule lobar location, presence of bronchus sign, and rEBUS view were associated with a diagnostic sample, but only rEBUS view showed an association in a multivariate analysis. The overall pneumothorax rate was 1.1% without pneumothorax requiring intervention, and there was no periprocedural bleeding. Conclusion: As an emerging technology in the Chinese population, SS-RAB can safely biopsy PPNs with strong diagnostic performance.

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Hemorrhagic Adverse Events of Transthoracic Needle Biopsy of the Lung in Patients with Pulmonary Hypertension: A Systematic Review and Meta-Analysis

Jang,

Darling,

Choudhary

et al. 2024

Journal of Vascular and Interventional Radiology

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Safety of Transbronchial Biopsies in Patients with Pulmonary Hypertension: Systematic Review and Meta-Analysis

Cited by 4 publications

References 39 publications

Robotic‐assisted bronchoscopy for the diagnosis of peripheral pulmonary lesions: A systematic review and meta‐analysis

Robotic‐assisted bronchoscopy for the diagnosis of peripheral pulmonary lesions: A systematic review and meta‐analysis

Shape-sensing Robotic-assisted Bronchoscopy (SS-RAB) in Sampling Peripheral Pulmonary Nodules

Hemorrhagic Adverse Events of Transthoracic Needle Biopsy of the Lung in Patients with Pulmonary Hypertension: A Systematic Review and Meta-Analysis

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