Efficacy and Safety of Pleural Cryobiopsy vs. Forceps Biopsy for Evaluation of Undiagnosed Pleural Effusion: A Systematic Review and Meta-Analysis

作者全名："Giri, Mohan; Dai, Haiyun; Guo, Shuliang; Li, Yishi; He, Lin; Zhuang, Rongjuan"

作者地址："[Giri, Mohan; Dai, Haiyun; Guo, Shuliang; Li, Yishi; Zhuang, Rongjuan] Chongqing Med Univ, Dept Pulm & Crit Care Med, Affiliated Hosp 1, Chongqing, Peoples R China; [He, Lin] Fuling Cent Hosp, Dept Resp & Crit Care Med, Chongqing, Peoples R China"

通信作者："Guo, SL (通讯作者)，Chongqing Med Univ, Dept Pulm & Crit Care Med, Affiliated Hosp 1, Chongqing, Peoples R China."

来源：FRONTIERS IN MEDICINE

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:000792149000001

JCR分区：Q1

影响因子：3.9

年份：2022

卷号：9

期号：　

开始页：　

结束页：　

文献类型：Review

关键词：pleural effusion; pleural cryobiopsy; forceps biopsy; meta-analysis; pleuroscopy

摘要："Background: Pleural cryobiopsy is a novel technique for the diagnosis of pleural pathologies. However, the safety and feasibility of this modality compared to standard forceps for pleural biopsy has not been fully elucidated. This systematic review and meta-analysis aims to establish the efficacy and safety of cryobiopsy for evaluation of undiagnosed pleural effusion.& nbsp;Methods: For this systematic review and meta-analysis, we searched PubMed, Embase, Scopus, and Web of science databases up to December 16, 2021 to identify relevant articles. We included randomized controlled trials, cohort studies, retrospectives studies and case series that compared pleural cryobiopsy and forceps biopsy. A qualitative assessment was performed using the QUADAS-2 tool.& nbsp;Results: Of the 365 articles identified by our search, 15 studies were eligible for inclusion. The specimen sizes obtained with cryobiopsy were significantly larger compared with forceps biopsy (Standard mean difference 1.16; 95 % CI: 0.51-1.82; P < 0.01). Furthermore, the cryobiopsy tissue specimens were deeper (OR 2.68; 95 % CI: 1.39-5.16; P < 0.01) and qualitatively better with less crush artifacts (OR 0.06; 95 % CI: 0.01-0.26; P < 0.01). There was no significant difference in diagnostic yield (OR 1.32; 95 % CI: 0.79-2.21; P = 0.29) and mild to moderate bleeding events (OR 1.21; 95 % CI: 0.64-2.29; P = 0.57) between pleural cryobiopsy and forceps biopsy. No publication bias was observed among these studies.& nbsp;Conclusions: Compared to flexible forceps biopsy pleural cryobiopsy obtained larger and deeper tissue specimens with less crush artifacts but does not show superiority for diagnostic yield. Further studies are still needed to verify these findings."

基金机构：Research projects on key disease prevention and control technologies in Chongqing [2019ZX002]; Chongqing Pulmonary Nodule office

基金资助正文：Funding This study was supported by Research projects on key disease prevention and control technologies in Chongqing (Project number: 2019ZX002) and Chongqing Pulmonary Nodule office.