Department of General Surgery, The People's Hospital of Fengqing, Lincang, 675900, PR China.
Department of Thoracic Surgery, The People's Hospital of Fengqing, Lincang, 675900, PR China.
J Cardiothorac Surg. 2024 Jun 14;19(1):332. doi: 10.1186/s13019-024-02781-0.
Pneumothorax is the most frequent complication after CT-guided percutaneous transthoracic lung biopsy (CT-PTLB). Many studies reported that injection of autologous blood patch (ABP) during biopsy needle withdrawal could reduce the pneumothorax and chest tube insertion rate after CT-PTLB, but the result is debatable. The aim of this systematic review and meta-analysis is to synthesize evidence regarding the efficacy of ABP procedure in patients receiving CT-PTLB.
Eligible studies were searched in Pubmed, Embase and Web of Science databases. The inclusion criteria were studies that assessed the relationship between ABP and the pneumothorax and/or chest tube insertion rate after CT-PTLB. Subgroup analyses according to study type, emphysema status and ABP technique applied were also conducted. Odds ratio (OR) with 95% confidence interval (CI) were calculated to examine the risk association.
A total of 10 studies including 3874 patients were qualified for analysis. Our analysis suggested that ABP reduced the pneumothorax (incidence: 20.0% vs. 27.9%, OR = 0.67, 95% CI = 0.48-0.66, P < 0.001) and chest tube insertion rate (incidence: 4.0% vs. 8.0%, OR = 0.47, 95% CI = 0.34-0.65, P < 0.001) after CT-PTLB. Subgroup analysis according to study type (RCT or retrospective study), emphysema status (with or without emphysema), and ABP technique applied (clotted or non-clotted ABP) were also performed and we found ABP reduced the pneumothorax and chest tube insertion rate in all subgroups.
Our study indicated that the use of ABP was effective technique in reducing the pneumothorax and chest tube insertion rate after CT-PTLB.
气胸是 CT 引导经皮肺穿刺活检（CT-PTLB）后最常见的并发症。许多研究报告称，在活检针拔出时注射自体血补丁（ABP）可以降低 CT-PTLB 后气胸和胸腔引流管插入率，但结果存在争议。本系统评价和荟萃分析的目的是综合评估 ABP 术在接受 CT-PTLB 的患者中的疗效证据。
在 Pubmed、Embase 和 Web of Science 数据库中搜索符合条件的研究。纳入标准为评估 ABP 与 CT-PTLB 后气胸和/或胸腔引流管插入率之间关系的研究。还根据研究类型、肺气肿状况和应用的 ABP 技术进行了亚组分析。使用比值比（OR）和 95%置信区间（CI）计算来检查风险关联。
共有 10 项研究，共 3874 例患者符合分析条件。我们的分析表明，ABP 降低了气胸（发生率：20.0%比 27.9%，OR=0.67，95%CI=0.48-0.66，P<0.001）和胸腔引流管插入率（发生率：4.0%比 8.0%，OR=0.47，95%CI=0.34-0.65，P<0.001）。还根据研究类型（RCT 或回顾性研究）、肺气肿状况（有或无肺气肿）和应用的 ABP 技术（凝固或未凝固的 ABP）进行了亚组分析，我们发现 ABP 在所有亚组中均降低了气胸和胸腔引流管插入率。
我们的研究表明，ABP 是一种有效降低 CT-PTLB 后气胸和胸腔引流管插入率的技术。
