Efficacy of saline tract sealing after CT-Guided lung biopsy: a systematic review and meta-analysis.

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.