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Post-Biopsy Manoeuvres to Reduce Pneumothorax Incidence in CT-Guided Transthoracic Lung Biopsies: A Systematic Review and Meta-analysis

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Abstract

This systematic review and meta-analysis investigated post-biopsy manoeuvres to reduce pneumothorax following computed tomography-guided percutaneous transthoracic lung biopsy. Twenty-one articles were included with 7080 patients. Chest drain insertion rates were significantly reduced by ninefold with the normal saline tract sealant compared to controls (OR 0.11, 95% CI 0.02–0.48), threefold with the rapid rollover manoeuvre to puncture site down (OR 0.34, 95% CI 0.18–0.63), threefold with the tract plug (OR 0.33, 95% CI 0.22–0.48) and threefold with the blood patch (OR 0.39, 95% CI 0.26–0.58). The absolute chest drain insertion rates were the lowest in the normal saline tract sealant (0.8% vs 7.3% for controls), rapid rollover (1.9% vs 5.2%), deep expiration and breath-hold on needle extraction (0.9% vs 1.8%) and standard rollover versus no rollover (2.6% vs 5.2%). These findings highlight post-biopsy manoeuvres which could help reduce pneumothorax and chest drain insertions following lung biopsies.

Level of Evidence

Level 1/no level of evidence, systematic review.

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Funding

This study was not supported by any funding.

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Author notes

  1. Ya Ruth Huo, Michael Vinchill Chan and Al-Rahim Habib are equal first authors.

Authors and Affiliations

  1. NSW Health, Bankstown-Campbelltown Hospital, Sydney, Australia

    Ya Ruth Huo

  2. Department of Radiology, Concord Repatriation General Hospital, Sydney, Australia

    Michael Vinchill Chan, Isaac Lui & Lloyd Ridley

  3. Faculty of Medicine, University of Sydney, Sydney, Australia

    Michael Vinchill Chan, Al-Rahim Habib & Lloyd Ridley

Authors
  1. Ya Ruth Huo
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  2. Michael Vinchill Chan
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  3. Al-Rahim Habib
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  4. Isaac Lui
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Correspondence to Michael Vinchill Chan.

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Huo, Y.R., Chan, M.V., Habib, AR. et al. Post-Biopsy Manoeuvres to Reduce Pneumothorax Incidence in CT-Guided Transthoracic Lung Biopsies: A Systematic Review and Meta-analysis. Cardiovasc Intervent Radiol 42, 1062–1072 (2019). https://doi.org/10.1007/s00270-019-02196-8

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  • DOI: https://doi.org/10.1007/s00270-019-02196-8

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