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：

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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。