BLEEDING RISK OF TRANSBRONCHIAL LUNG CRYOBIPSY VS FORCEPS BIOPSY IN INTERSTITIAL LUNG DISEASE PATIENTS: A META-ANALYSIS

Abstract

TOPIC: Procedures TYPE: Original Investigations PURPOSE: Transbronchial Lung Cryobiopsy (TBLC) is becoming a more novel method for sampling lung tissue for interstitial lung disease (ILD). Studies have shown that high-quality tissue samples can be had with TBLC. A major complication from TBLC is the bleeding risk. This meta-analysis study examines the bleeding risk of TBLC vs forceps biopsy in sampling ILD lung tissue METHODS: We conducted a systematic review and meta-analysis of studies that investigated the bleeding risk of TBLC vs Forceps biopsy in sampling lung tissue of ILD patients. We performed a comprehensive search in the databases of PubMed/MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials from inception through April 2021. We considered randomized controlled trials, cohort studies, case-control studies, and case series. We excluded abstracts, animal studies, case reports, reviews, editorials, and letters to editors. PRISMA criteria for evaluating studies were used. From each study, we collected the number of patients with ILD who underwent TBLC vs forceps biopsy and associated bleeding risk. The events recorded were bleeding risk. The random-effects model was used to calculate the risk ratios (RR), and confidence intervals (CI). A p value <0.05 was considered statistically significant. Heterogeneity was assessed using the Higgins I2 index RESULTS: Studies were examined which fit the search criteria with 455 patients. The bleeding risk from TBLC vs forceps biopsy for ILD lung samples showed pooled risk ratio of 1.36 (CI 0.80, 2.30), I2=91). Most of the patients in the study had no bleeding events after the first episode. CONCLUSIONS: Our meta-analysis demonstrated that ILD patients who underwent cryobiopsy had increased bleeding risk, but the conclusion was not statistically significant increased. Further studies need to be undertaken to help increase the patient sample size and delineate the bleeding risk for cryobiopsy. CLINICAL IMPLICATIONS: There is uncertainty whether cryobiopsy in ILD patients increases their bleeding risk. Previous studies have shown higher diagnostic yield for lung tissue taken with TBLC. The meta-analysis shows there were more bleeding events with TBLC compared to forceps, but this was not statistically significant. Thus cryobiopsy should be considered for ILD tissue biopsy. DISCLOSURES: No relevant relationships by prabath herath mudiyanselage, source=Web Response No relevant relationships by Saffa Iftikhar, source=Web Response No relevant relationships by Nithin Kesireddy, source=Web Response No relevant relationships by Waleed Khokher, source=Web Response