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Post-Biopsy Manoeuvres to Reduce Pneumothorax Incidence in CT-Guided Transthoracic Lung Biopsies: A Systematic Review and Meta-analysis.
CardioVascular and Interventional Radiology ( IF 2.8 ) Pub Date : 2019-03-14 , DOI: 10.1007/s00270-019-02196-8
Ya Ruth Huo 1 , Michael Vinchill Chan 2, 3 , Al-Rahim Habib 3 , Isaac Lui 2 , Lloyd Ridley 2, 3
Affiliation  

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.

中文翻译:

活检后的操作可减少CT引导下经胸肺活检的气胸发生率:系统评价和荟萃分析。

这项系统的回顾和荟萃分析调查了活检后的操作,以减少计算机断层扫描引导的经皮经胸肺活检后的气胸。纳入21篇文章,涉及7080名患者。与对照组相比,普通生理盐水密封剂的胸水插入率显着降低了九倍(OR 0.11,95%CI 0.02-0.48),而快速翻转操作向下穿刺部位则降低了三倍(OR 0.34,95%CI 0.18-0.63) ),使用导管塞三倍(OR 0.33,95%CI 0.22-0.48),使用血液补丁三倍(OR 0.39,95%CI 0.26-0.58)。在生理盐水密封胶中,绝对的胸水插入率最低(对照组为0.8%vs 7.3%),快速翻身(1.9%vs 5.2%),深层呼气和拔针时屏息最低(0.9%vs 1.)。8%)和标准翻转(无翻转)(2.6%和5.2%)。这些发现强调了活检后的操作,可以减少肺活检后的气胸和胸腔引流。证据级别:1级/无证据级别,系统审查。
更新日期:2019-03-12
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