Clinical radiology · 2026
Saline tract sealing to prevent pneumothorax and chest tube placement after computed tomography (CT)-guided lung biopsy: a systematic review and meta-analysis.
СтатьяСистематический обзорМетаанализНазвание и аннотация: Перевод в очереди
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Pille J J, Pinheiro B N, Alano J M, Luna A M, Lopes de Souza M B, Irudhayaraj C D J, Vitte S H, Rajaram R, Gregory M K, Munaretto G M
Аннотация
AIM: Pneumothorax is the most common complication of computed tomography (CT)-guided lung biopsy, occurring in approximately 25% of cases, with 5-6% requiring chest tube placement. Tract-sealing techniques such as autologous blood, fibrin glue, and collagen plugs can reduce this risk but are costly or may cause local reactions. Saline tract sealing is an inexpensive and widely available alternative, but evidence of its effectiveness is limited.
MATERIALS AND METHODS: We performed a systematic review and meta-analysis of randomised controlled trials and comparative cohort studies including adults undergoing CT-guided percutaneous lung biopsy, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The intervention was immediate instillation of sterile saline into the biopsy tract, compared with no sealing. The outcomes analysed were postbiopsy pneumothorax and chest tube placement.
RESULTS: Seven studies (1455 patients; 680 received saline) were included. Saline tract sealing significantly reduced the risk of pneumothorax (risk ratios [RR]: 0.46; 95% confidence interval [CI]: 0.35-0.61; P < 0.00001) and the need for chest tube placement (RR: 0.22; 95% CI: 0.12-0.42; P < 0.0001).
CONCLUSION: Saline tract sealing is associated with a significant reduction in pneumothorax and the need for chest tube placement after CT-guided lung biopsy and may be considered an adjunctive technique during the procedure.
MATERIALS AND METHODS: We performed a systematic review and meta-analysis of randomised controlled trials and comparative cohort studies including adults undergoing CT-guided percutaneous lung biopsy, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The intervention was immediate instillation of sterile saline into the biopsy tract, compared with no sealing. The outcomes analysed were postbiopsy pneumothorax and chest tube placement.
RESULTS: Seven studies (1455 patients; 680 received saline) were included. Saline tract sealing significantly reduced the risk of pneumothorax (risk ratios [RR]: 0.46; 95% confidence interval [CI]: 0.35-0.61; P < 0.00001) and the need for chest tube placement (RR: 0.22; 95% CI: 0.12-0.42; P < 0.0001).
CONCLUSION: Saline tract sealing is associated with a significant reduction in pneumothorax and the need for chest tube placement after CT-guided lung biopsy and may be considered an adjunctive technique during the procedure.