Transbronchial Lung Cryobiopsy and Video-Assisted Thoracoscopic Lung Biopsy in the Diagnosis of Diffuse Parenchymal Lung Disease: A Meta-analysis of Diagnostic Test Accuracy.

Transbronchial Lung Cryobiopsy and Video-Assisted Thoracoscopic Lung Biopsy in the Diagnosis of Diffuse Parenchymal Lung Disease: A Meta-analysis of Diagnostic Test Accuracy.

Ann Am Thorac Soc. 2017 Apr 11;:

Authors: Iftikhar IH, Alghothani L, Sardi A, Berkowitz D, Musani AI

Abstract
BACKGROUND: Transbronchial lung cryobiopsy (TBLC) is increasingly being used for the assessment of diffuse pulmonary lung diseases (DPLD). Several studies have shown larger biopsy samples and higher yields compared to conventional transbronchial biopsies. However, the higher risk of bleeding and other complications has raised concerns for widespread use of this modality.
OBJECTIVE: To study the diagnostic accuracy and safety profile of TBLC and compare with video assisted thoracoscopic (VATS), by reviewing available evidence from the literature.
DATA SOURCES: Medline and PubMed were searched from inception until December 2016.
DATA EXTRACTION: Data on diagnostic performance was abstracted by constructing two-by-two contingency tables for each study. Data on a priori selected safety outcomes was collected, Synthesis: Risk of bias was assessed with QUADAS. Random effects meta-analyses were performed to obtain summary estimates of the diagnostic accuracy. The pooled diagnostic yield of TBLC and VATS were 83.7% (76.9% to 88.8%), and 92.7% (87.6% to 95.8%), respectively. Pooled sensitivity of TBLC and VATS were 87% (85% to 89%), and 91.0% (89% to 92%). Pooled specificity of TBLC and VATS were 57% (40% to 73%) and 58% (31% to 81%). The incidence of grade 2 (moderate to severe) endobronchial bleeding after TBLC and of post-procedural pneumothorax was 4.9% (2.2% to 10.7%), 9.5% (5.9% to 14.9%), respectively.
CONCLUSIONS: With diagnostic test accuracy, comparable to that of VATS, and an acceptable safety profile, TBLC could be considered an alternative in the evaluation of patients with DPLDs.

PMID: 28399377 [PubMed - as supplied by publisher]

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