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

Détails

ID Serval
serval:BIB_8511F4A6DF55
Type
Article: article d'un périodique ou d'un magazine.
Sous-type
Synthèse (review): revue aussi complète que possible des connaissances sur un sujet, rédigée à partir de l'analyse exhaustive des travaux publiés.
Collection
Publications
Titre
Diagnostic yield and safety of electromagnetic navigation bronchoscopy for lung nodules: a systematic review and meta-analysis
Périodique
Respiration
Auteur(s)
Gex Grégoire, Pralong Jacques A., Combescure Christophe, Seijo Luis, Rochat Thierry, Soccal Paola M.
ISSN
1423-0356 (Electronic)
ISSN-L
0025-7931
Statut éditorial
Publié
Date de publication
2014
Peer-reviewed
Oui
Volume
87
Numéro
2
Pages
165-176
Langue
anglais
Notes
Publication types: Journal Article ; Meta-Analysis ; Review
Publication Status: ppublish
Résumé
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.

Mots-clé
Bronchoscopy/adverse effects, Bronchoscopy/methods, Bronchoscopy/statistics & numerical data, Humans, Solitary Pulmonary Nodule/diagnosis
Pubmed
Web of science
Open Access
Oui
Création de la notice
11/09/2017 16:54
Dernière modification de la notice
08/05/2019 21:21
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