Progress Of Transbronchial Cryobiopsy In The Diagnosis And Treatment Of Peripheral Lung Lesions:A Meta Analysis

Objective:To investigate the diagnostic value and safety of transbronchial cryobiopsy(TBCB)versus transbronchial forceps biopsy(TBFB)for peripheral lung lesions.Methods:The search terms of"peripheral lung lesions""lung peripheral nodules""isolated lung nodules"and"transbronchial frozen biopsy"were searched in CNKI,Pub Med,Cochrane Library,Embase and Wanfang Medical Network for studies related to transbronchial lung cryobiopsy until September 10,2022.Eligible studies were selected for quality assessment,and subgroup analysis and sensitivity analysis of the final included articles.The outcome indicators were the diagnostic rate,the incidence of major bleeding and pneumothorax and material area,which were statistically analyzed using STATA version 16.0.Results:A total of 13 studies and 816 patients were included.Eight of the two-arm studies included 618 patients,280 in the TBCB group,338 in the TBFB group,and 198 in five self-control trials.The analysis results showed that the material area of the TBCB group was 2～9 times that of the TBFB group.Compared with TBFB,TBCB can improve the diagnostic rate of the lung peripheral lesions.There were statistical differences in the diagnostic rate of the lung peripheral lesions between TBCB group and TBFB group(Log OR=0.48,95%CI(0.03～0.93),I~2=54.11%).And TBCB does not increased the risk of bleeding,(Log OR=0.71,95%CI(-0.07～1.50),I~2=62.74%).Meanwhile,There was no difference in pneumothorax incidence between the two groups(Log OR=-0.07,95%CI(-0.75～0.61)).Conclusion:Transbronchial cryobiopsy is better than TBFB in diagnostic rate and material area,and it does not increase the risk of bleeding or pneumothorax with the appropriate number of blocks.