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Efficacy of saline tract sealing after CT-Guided lung biopsy: a systematic review and meta-analysis
A T Kayaoglu1, J M Almeida2, V V Varela Betancourt3
1Recep Tayyip Erdogan University Research and Training Hospital, Turkey.
Introduction:
CT-guided percutaneous transthoracic lung biopsy is a high-value procedure with risks such as pneumothorax and chest tube placement. Several needle-tract sealing techniques have been proposed to reduce post-biopsy pneumothorax, although evidence regarding saline tract sealing remains limited. This study updated a meta-analysis comparing normal saline tract sealing to usual care for pneumothorax and chest tube placement in guided lung biopsies.
Methods:
Embase, Scopus, PubMed, and Cochrane databases were systematically searched for studies comparing tract instillation with normal saline versus usual care in patients undergoing CT-guided lung biopsy. The outcomes assessed were pneumothorax and chest tube placement. Risk ratios (RR) with 95% confidence intervals (CI) were pooled with a random effects model.
Results:
Seven studies were included following our inclusion criteria, comprising a total of 1,455 patients. Of these, 680 patients (46.7%) underwent tract instillation with saline after CT-guided lung biopsy. Compared to usual care, saline tract instillation was associated with significantly lower rates of pneumothorax (risk ratio 0.46; 95% CI 0.32-0.67; p=0.002; I2 = 50%) and chest tube placement (risk ratio 0.24; 95% CI 0.14-0.40; p<0.001; I2 = 0%).
Conclusions:
In patients undergoing CT-guided lung biopsy, tract sealing with normal saline reduces the incidence of pneumothorax and chest tube placement, compared to usual care.
Prospero Registration:
CRD420251249441.
