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Meta-Analysis
. 2023 Apr 1;30(2):99-113.
doi: 10.1097/LBR.0000000000000865.

Role of Transbronchial Lung Cryobiopsy in the Diagnosis of Interstitial Lung Disease: A Meta-analysis of 68 Studies and 6300 Patients

Yazan Zayed  1 , Bashar N Alzghoul  1 , Ryan Hyde  1 , Zerka Wadood  1 , Momen Banifadel  2 , Majd Khasawneh  1 , Phillip Brandon Maharrey  1 , Haneen Saker  3 , Christopher Harden  1 , Gabrielle Barnes  1 , Diana Gomez-Manjarres  1 , Divya Patel  1 , Ibrahim Faruqi  1 , Borna Mehrad  1 , Hiren J Mehta  1
Affiliations
Meta-Analysis

Role of Transbronchial Lung Cryobiopsy in the Diagnosis of Interstitial Lung Disease: A Meta-analysis of 68 Studies and 6300 Patients

Yazan Zayed et al. J Bronchology Interv Pulmonol. .

Abstract

Background: Diagnosis of interstitial lung disease (ILD) is based on multidisciplinary team discussion (MDD) with the incorporation of clinical, radiographical, and histopathologic information if available. We aim to evaluate the diagnostic yield and safety outcomes of transbronchial lung cryobiopsy (TBLC) in the diagnosis of ILD.

Methods: We conducted a meta-analysis by comprehensive literature search to include all studies that evaluated the diagnostic yields and/or adverse events with TBLC in patients with ILD. We calculated the pooled event rates and their 95% confidence intervals (CIs) for the diagnostic yield by MDD, histopathologic diagnostic yield, and various clinical adverse events.

Results: We included 68 articles (44 full texts and 24 abstracts) totaling 6386 patients with a mean age of 60.7±14.1 years and 56% men. The overall diagnostic yield of TBLC to achieve a definite or high-confidence diagnosis based on MDD was 82.3% (95% CI: 78.9%-85.2%) and histopathologic diagnosis of 72.5% (95% CI: 67.7%-76.9%). The overall rate of pneumothorax was 9.6% (95% CI: 7.9%-11%), while the rate of pneumothorax requiring drainage by a thoracostomy tube was 5.3% (95% CI: 4.1%-6.9%). The rate of moderate bleeding was 11.7% (95% CI: 9.1%-14.9%), while the rate of severe bleeding was 1.9% (95% CI: 1.4%-2.6%). The risk of mortality attributed to the procedure was 0.9% (95% CI: 0.7%-1.3%).

Conclusion: Among patients with undiagnosed or unclassified ILD requiring tissue biopsy for diagnosis, transbronchial cryobiopsy represents a reliable alternative to surgical lung biopsy with decreased incidence of various clinical adverse events.

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Conflict of interest statement

Disclosure: There is no conflict of interest or other disclosures.

Figures

Figure 1:
Figure 1:
Flow chart of literature search and study selection
Figure 2:
Figure 2:
Funnel plot for publication bias showed low risk for publication bias
Figure 3:
Figure 3:
Forest plot of diagnostic yield by multidisciplinary team discussion (MDD)
Figure 4:
Figure 4:
Forest plot for event rate of pneumothorax showing event rate for pneumothorax
Figure 5:
Figure 5:
Forest plot for event rate of severe bleeding showing rate of severe bleeding
See this image and copyright information in PMC

Comment in

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