Diagnostic yield and safety of electromagnetic navigation bronchoscopy for lung nodules: a systematic review and meta-analysis

Details

Serval ID
serval:BIB_8511F4A6DF55
Type
Article: article from journal or magazin.
Publication sub-type
Review (review): journal as complete as possible of one specific subject, written based on exhaustive analyses from published work.
Collection
Publications
Title
Diagnostic yield and safety of electromagnetic navigation bronchoscopy for lung nodules: a systematic review and meta-analysis
Journal
Respiration
Author(s)
Gex Grégoire, Pralong Jacques A., Combescure Christophe, Seijo Luis, Rochat Thierry, Soccal Paola M.
ISSN
1423-0356 (Electronic)
ISSN-L
0025-7931
Publication state
Published
Issued date
2014
Peer-reviewed
Oui
Volume
87
Number
2
Pages
165-176
Language
english
Notes
Publication types: Journal Article ; Meta-Analysis ; Review
Publication Status: ppublish
Abstract
Electromagnetic navigation bronchoscopy (ENB) is an emerging endoscopic technique for the diagnosis of peripheral lung lesions. A thorough analysis of ENB's yield and safety is required for comparison to other sampling modalities.
To describe ENB's yield and safety profile.
The MEDLINE and EMBASE databases were systematically searched for studies reporting ENB's yield for peripheral lung lesions. Two independent investigators extracted data and rated each study on a scale of methodological quality. Clearly defined performance outcomes were reconstructed and meta-analyzed. Subgroup analysis and meta-regression were used to identify possible sources of study heterogeneity.
A total of 15 trials were included (1,033 lung nodules). A positive and definitive diagnosis was obtained after 64.9% of all ENB procedures (95% CI 59.2-70.3). Overall diagnostic accuracy was 73.9% (95% CI 68.0-79.2). Sensitivity to detect cancer was 71.1% (95% CI 64.6-76.8), with a negative predictive value of 52.1% (95% CI 43.5-60.6). Pneumothorax occurred in 3.1% of patients, requiring chest tube drainage in 1.6% of these cases. Original trials identified 6 variables associated with higher ENB yields: nodule location in the upper or middle lobes, nodule size, lower registration error, presence of a bronchus sign on CT imaging, combined use of an ultrasonic radial probe, and catheter suctioning as a sampling technique. Heterogeneity exploration revealed that studies using general anesthesia or rapid on-site cytological evaluation reported better yields.
ENB is effective and particularly safe. Prospective studies are needed to clarify the role of several variables conditioning the yield of this technique.

Keywords
Bronchoscopy/adverse effects, Bronchoscopy/methods, Bronchoscopy/statistics & numerical data, Humans, Solitary Pulmonary Nodule/diagnosis
Pubmed
Web of science
Open Access
Yes
Create date
11/09/2017 15:54
Last modification date
20/08/2019 14:44
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