scholarly journals Diagnostic Yield and Safety of Electromagnetic Navigation Bronchoscopy for Lung Nodules: A Systematic Review and Meta-Analysis

Respiration ◽  
2014 ◽  
Vol 87 (2) ◽  
pp. 165-176 ◽  
Author(s):  
Gregoire Gex ◽  
Jacques A. Pralong ◽  
Christophe Combescure ◽  
Luis Seijo ◽  
Thierry Rochat ◽  
...  
Keyword(s):  
Systematic Review ◽  
Diagnostic Yield ◽  
Meta Analysis ◽  
Lung Nodules ◽  
Electromagnetic Navigation

scholarly journals Diagnostic yield of EUS-guided through-the-needle microforceps biopsy versus EUS-FNA of pancreatic cystic lesions: a systematic review and meta-analysis

2020 ◽  
Vol 08 (05) ◽  
pp. E656-E667 ◽  
Author(s):  
Donevan R. Westerveld ◽  
Sandeep A. Ponniah ◽  
Peter V. Draganov ◽  
Dennis Yang
Keyword(s):  
Systematic Review ◽  
Sensitivity And Specificity ◽  
Diagnostic Yield ◽  
Meta Analysis ◽  
Concordance Rate ◽  
Surgical Pathology ◽  
Adverse Event Rate ◽  
Secondary Outcome ◽  
Pancreatic Cysts ◽  
Cyst Type

Abstract Background and study aims Accurate diagnosis and risk stratification of pancreatic cysts (PCs) is challenging. The aim of this study was to perform a systematic review and meta-analysis to assess the feasibility, safety, and diagnostic yield of endoscopic ultrasound-guided through-the-needle biopsy (TTNB) versus fine-needle aspiration (FNA) in PCs. Methods Comprehensive search of databases (PubMed, EMBASE, Cochrane, Web of Science) for relevant studies on TTNB of PCs (from inception to June 2019). The primary outcome was to compare the pooled diagnostic yield and concordance rate with surgical pathology of TTNB histology and FNA cytology of PCs. The secondary outcome was to estimate the safety profile of TTNB. Results: Eight studies (426 patients) were included. The diagnostic yield was significantly higher with TTNB over FNA for a specific cyst type (OR: 9.4; 95 % CI: [5.7–15.4]; I2 = 48) or a mucinous cyst (MC) (OR: 3.9; 95 % CI: [2.0–7.4], I2 = 72 %). The concordance rate with surgical pathology was significantly higher with TTNB over FNA for a specific cyst type (OR: 13.5; 95 % CI: [3.5–52.3]; I2 = 48), for a MC (OR: 8.9; 95 % [CI: 1.9–40.8]; I2 = 29), and for MC histologic severity (OR: 10.4; 95 % CI: [2.9–36.9]; I2 = 0). The pooled sensitivity and specificity of TTNB for MCs were 90.1 % (95 % CI: [78.4–97.6]; I2 = 36.5 %) and 94 % (95 % CI: [81.5–99.7]; I2 = 0), respectively. The pooled adverse event rate was 7.0 % (95 % CI: [2.3–14.1]; I2 = 82.9). Conclusions TTNB is safe, has a high sensitivity and specificity for MCs and may be superior to FNA cytology in risk-stratifying MCs and providing a specific cyst diagnosis.

scholarly journals Carbon dioxide versus room air insufflation during balloon-assisted enteroscopy: A systematic review with meta-analysis

2017 ◽  
Vol 05 (01) ◽  
pp. E67-E75 ◽  
Author(s):  
Ashok Shiani ◽  
Seth Lipka ◽  
Andrew Lai ◽  
Andrea Rodriguez ◽  
Christian Andrade ◽  
...  
Keyword(s):  
Carbon Dioxide ◽  
Systematic Review ◽  
Adverse Events ◽  
Diagnostic Yield ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Insertion Depth ◽  
Co2 Insufflation ◽  
Air Insufflation

Abstract Background and study aims Carbon dioxide (CO2) insufflation has been suggested to be an ideal alternative to room air insufflation to reduce trapped air within the bowel lumen after balloon assisted enteroscopy (BAE). We performed a systematic review and meta-analysis to assess the safety and efficacy of utilizing CO2 insufflation as compared to room air during BAE. Patients and methods The primary outcome is mean change in visual analog scale (VAS; 10 cm) at 1, 3, and 6 hours to assess pain. Secondary outcomes include insertion depth (anterograde or retrograde), adverse events, total enteroscopy rate, diagnostic yield, mean anesthetic dosage, and PaCO2 at procedure completion. We searched MEDLINE and the Cochrane Central Register of Controlled Trials (CENTRAL) from inception until May 2015. Multiple independent extractions were performed, the process was executed as per the standards of the Cochrane collaboration. Results Four randomized controlled trials (RCTs) were included in the meta-analysis. VAS at 6 hours favored CO2 over room air (MD 0.13; 95 % CI 0.01, 0.25; p = 0.03). Anterograde insertion depth (cm) was improved in the CO2 group (MD, 58.2; 95 % CI 17.17, 99.23; p = 0.005), with an improvement in total enteroscopy rate in the CO2 group (RR 1.91; 95 % CI 1.20, 3.06; p = 0.007). Mean dose of propofol (mg) favored CO2 compared to air (MD, – 70.53; 95 % CI – 115.07, – 25.98; P = 0.002). There were no differences in adverse events in either group. Conclusions Despite the ability of CO2 to improve insertion depth and decrease amount of anesthesia required, further randomized control trials are needed to determine the agent of choice for insufflation in balloon assisted enteroscopy.

Tu1348 - Diagnostic Yield of Pancreatic Cancer Screening in High-Risk Individuals: A Systematic Review and Meta-Analysis

2018 ◽  
Vol 154 (6) ◽  
pp. S-938-S-939
Author(s):  
Juan E. Corral ◽  
Karl Mareth ◽  
Douglas L. Riegert-Johnson ◽  
Ananya Das ◽  
Michael B. Wallace
Keyword(s):  
Systematic Review ◽  
Pancreatic Cancer ◽  
Cancer Screening ◽  
High Risk ◽  
Diagnostic Yield ◽  
Meta Analysis ◽  
Pancreatic Cancer Screening

Tu1685 Diagnostic Yield of EUS-Guided FNA for Malignant Biliary Stricture: a Systematic Review and Meta-Analysis

2015 ◽  
Vol 81 (5) ◽  
pp. AB558-AB559
Author(s):  
Mehdi Mohamadnejad ◽  
Anahita Sadeghi ◽  
Farhad Islami ◽  
Mohammad Biglari ◽  
Abbas Keshtkar ◽  
...  
Keyword(s):  
Systematic Review ◽  
Biliary Stricture ◽  
Diagnostic Yield ◽  
Meta Analysis ◽  
Malignant Biliary Stricture

scholarly journals Minimally Invasive Methods for Staging in Lung Cancer: Systematic Review and Meta-Analysis

2016 ◽  
Vol 2016 ◽  
pp. 1-11 ◽  
Author(s):  
Gonzalo Labarca ◽  
Carlos Aravena ◽  
Francisco Ortega ◽  
Alex Arenas ◽  
Adnan Majid ◽  
...  
Keyword(s):  
Systematic Review ◽  
Diagnostic Yield ◽  
Meta Analysis ◽  
Endobronchial Ultrasound ◽  
Safe Procedure ◽  
Mediastinal Staging ◽  
Prospective Trials ◽  
Sensitivity Specificity ◽  
Search Quality ◽  
Quality Assessments

Introduction. Endobronchial ultrasound (EBUS) is a procedure that provides access to the mediastinal staging; however, EBUS cannot be used to stage all of the nodes in the mediastinum. In these cases, endoscopic ultrasound (EUS) is used for complete staging.Objective. To provide a synthesis of the evidence on the diagnostic performance of EBUS + EUS in patients undergoing mediastinal staging.Methods. Systematic review and meta-analysis to evaluate the diagnostic yield of EBUS + EUS compared with surgical staging. Two researchers performed the literature search, quality assessments, data extractions, and analyses. We produced a meta-analysis including sensitivity, specificity, and likelihood ratio analysis.Results. Twelve primary studies (1515 patients) were included; two were randomized controlled trials (RCTs) and ten were prospective trials. The pooled sensitivity for combined EBUS + EUS was 87% (CI 84–89%) and the specificity was 99% (CI 98–100%). For EBUS + EUS performed with a single bronchoscope group, the sensitivity improved to 88% (CI 83.1–91.4%) and specificity improved to 100% (CI 99-100%).Conclusion. EBUS + EUS is a highly accurate and safe procedure. The combined procedure should be considered in selected patients with lymphadenopathy noted at stations that are not traditionally accessible with conventional EBUS.

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