Post-Biopsy Manoeuvres to Reduce Pneumothorax Incidence in CT-Guided Transthoracic Lung Biopsies: A Systematic Review and Meta-analysis
| Autor: | Al-Rahim R. Habib, Lloyd J Ridley, Isaac Lui, Ya Ruth Huo, Michael Vinchill Chan |
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| Rok vydání: | 2019 |
| Předmět: |
Image-Guided Biopsy
Male medicine.medical_specialty Percutaneous medicine.medical_treatment Lung biopsy Radiography Interventional 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine Risk Factors Biopsy Humans Medicine Radiology Nuclear Medicine and imaging Expiration Lung Saline Aged Retrospective Studies medicine.diagnostic_test business.industry Ultrasound Pneumothorax Middle Aged medicine.disease Surgery medicine.anatomical_structure Female Tomography X-Ray Computed Cardiology and Cardiovascular Medicine business |
| Zdroj: | CardioVascular and Interventional Radiology. 42:1062-1072 |
| ISSN: | 1432-086X 0174-1551 |
| Popis: | This systematic review and meta-analysis investigated post-biopsy manoeuvres to reduce pneumothorax following computed tomography-guided percutaneous transthoracic lung biopsy. Twenty-one articles were included with 7080 patients. Chest drain insertion rates were significantly reduced by ninefold with the normal saline tract sealant compared to controls (OR 0.11, 95% CI 0.02-0.48), threefold with the rapid rollover manoeuvre to puncture site down (OR 0.34, 95% CI 0.18-0.63), threefold with the tract plug (OR 0.33, 95% CI 0.22-0.48) and threefold with the blood patch (OR 0.39, 95% CI 0.26-0.58). The absolute chest drain insertion rates were the lowest in the normal saline tract sealant (0.8% vs 7.3% for controls), rapid rollover (1.9% vs 5.2%), deep expiration and breath-hold on needle extraction (0.9% vs 1.8%) and standard rollover versus no rollover (2.6% vs 5.2%). These findings highlight post-biopsy manoeuvres which could help reduce pneumothorax and chest drain insertions following lung biopsies. LEVEL OF EVIDENCE: Level 1/no level of evidence, systematic review. |
| Databáze: | OpenAIRE |
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