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Minimally invasive interventions for biopsy of malignancy-suspected pulmonary nodules: a systematic review and meta-analysis
Miotto, André; Perfeito, João Aléssio Juliano; Pacheco, Rafael Leite; Latorraca, Carolina de Oliveira Cruz; Riera, Rachel.
Afiliação
  • Miotto, André; Universidade Federal de São Paulo. Thoracic Surgery Division. São Paulo. BR
  • Perfeito, João Aléssio Juliano; Universidade Federal de São Paulo. Thoracic Surgery Division. São Paulo. BR
  • Pacheco, Rafael Leite; Centro Universitário São Camilo. São Paulo. BR
  • Latorraca, Carolina de Oliveira Cruz; Associação Paulista para o Desenvolvimento da Medicina. Center of Health Technology Assessment. São Paulo. BR
  • Riera, Rachel; Universidade Federal de São Paulo. Discipline of Evidence-Based Medicine. São Paulo. BR
São Paulo med. j ; São Paulo med. j;141(5): e2022543, 2023. tab, graf
Article em En | LILACS-Express | LILACS | ID: biblio-1432465
Biblioteca responsável: BR1.1
ABSTRACT
ABSTRACT

BACKGROUND:

Imaging tests are important for diagnosis during the management of pulmonary nodules; however, biopsy is required to confirm the malignancy.

OBJECTIVES:

To compare the effects of different techniques used for the biopsy of a pulmonary nodule. DESIGN AND

SETTING:

Systematic review and meta-analysis were conducted using Cochrane methodology in São Paulo, São Paulo, Brazil.

METHODS:

We conducted a systematic review of randomized controlled trials (RCTs) on minimally invasive techniques, including tomography-guided percutaneous biopsy (PERCUT), transbronchial biopsies with fluoroscopy (FLUOR), endobronchial ultrasound (EBUSR), and electromagnetic navigation (NAVIG). The primary outcomes were diagnostic yield, major adverse events, and need for another approach.

RESULTS:

Seven RCTs were included (913 participants; 39.2% female, mean age 59.28 years). Little to no increase was observed in PERCUT over FLUOR (P = 0.84), PERCUT over EBUSR (P = 0.32), and EBUSR over NAVIG (P = 0.17), whereas a slight increase was observed in NAVIG over FLUOR (P = 0.17); however, the evidence was uncertain. EBUSR may increase the diagnostic yield over FLUOR (P = 0.34). PERCUT showed little to no increase in all bronchoscopic techniques, with uncertain evidence (P = 0.02).

CONCLUSION:

No biopsy method is definitively superior to others. The preferred approach must consider availability, accessibility, and cost, as safety and diagnostic yield do not differ. Further RCTs planned, conducted, and reported with methodological rigor and transparency are needed, and additional studies should assess cost and the correlation between nodule size and location, as well as their association with biopsy results. SYSTEMATIC REVIEW REGISTRATION PROSPERO database, CRD42018092367 -https//www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=92367.
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Texto completo: 1 Coleções: 01-internacional Base de dados: LILACS Tipo de estudo: Clinical_trials / Systematic_reviews Idioma: En Revista: São Paulo med. j Assunto da revista: Cirurgia Geral / Ciˆncia / Ginecologia / MEDICINA / Medicina Interna / Obstetr¡cia / Pediatria / Sa£de Mental / Sa£de P£blica Ano de publicação: 2023 Tipo de documento: Article País de afiliação: Brasil País de publicação: Brasil
Texto completo
Adicionar na Minha BVS
Imprimir
XML
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: LILACS Tipo de estudo: Clinical_trials / Systematic_reviews Idioma: En Revista: São Paulo med. j Assunto da revista: Cirurgia Geral / Ciˆncia / Ginecologia / MEDICINA / Medicina Interna / Obstetr¡cia / Pediatria / Sa£de Mental / Sa£de P£blica Ano de publicação: 2023 Tipo de documento: Article País de afiliação: Brasil País de publicação: Brasil