comprehensive meta analysis 2.2.064 download

International consensus guidelines for the diagnosis and treatment of interstitial lung diseases (ILDs) ( 2, 3) indicate that in approximately 50% of cases, chest high-resolution computed tomography may not be sufficient to diagnose idiopathic pulmonary fibrosis (IPF), and surgical lung biopsy is recommended to distinguish usual interstitial pneumonia (UIP) from other ILDs ( 4). DPLDs differ widely in their etiology, clinicopathologic features, therapeutic options, and prognosis ( 1). The incidence of grade 2 (moderate to severe) endobronchial bleeding after transbronchial lung cryobiopsy and of post-procedural pneumothorax was 4.9% (2.2–10.7%) and 9.5% (5.9–14.9%), respectively.Ĭonclusions: Although the diagnostic test accuracy measures of transbronchial lung cryobiopsy lag behind those of VATS, with an acceptable safety profile and potential cost savings, the former could be considered as an alternative in the evaluation of patients with diffuse parenchymal lung diseases.ĭiffuse parenchymal lung diseases (DPLDs) are a heterogeneous group of more than 200 pulmonary conditions that manifest with diffuse and patchy involvement of lung parenchyma. Results: The pooled diagnostic yield, pooled sensitivity, and pooled specificity of transbronchial lung cryobiopsy were 83.7% (76.9–88.8%), 87% (85–89%), and 57% (40–73%), respectively. Random effects meta-analyses were performed to obtain summary estimates of the diagnostic accuracy. Risk of bias was assessed with the Quality Assessment of Diagnostic Accuracy Studies tool. Data on a priori selected safety outcomes were collected. Data on diagnostic performance were abstracted by constructing two-by-two contingency tables for each study. Methods: Medline and PubMed were searched from inception until December 2016. Objectives: To study the diagnostic accuracy and safety profile of transbronchial lung cryobiopsy and compare with video-assisted thoracoscopic surgery (VATS) by reviewing available evidence from the literature. However, the higher risk of bleeding and other complications has raised concerns for widespread use of this modality. Several studies have shown larger biopsy samples and higher yields compared with conventional transbronchial biopsies. Rationale: Transbronchial lung cryobiopsy is increasingly being used for the assessment of diffuse parenchymal lung diseases.

Comprehensive meta analysis 2.2.064 download