Masahiro Yanagiya1, Takuya Kawahara2, Keiko Ueda3, Daisuke Yoshida4, Hirokazu Yamaguchi1, Masaaki Sato1. 1. Department of Thoracic Surgery, The University of Tokyo Graduate School of Medicine, Tokyo, Japan. 2. Biostatistics Division, Clinical Research Support Center, The University of Tokyo Hospital, Tokyo, Japan. 3. Management Division, Clinical Research Support Center, The University of Tokyo Hospital, Tokyo, Japan. 4. Department of Surgery, Asahi General Hospital, Asahi, Japan.
Abstract
OBJECTIVES: Recent studies have suggested the usefulness of preoperative bronchoscopic marking techniques for the localization of pulmonary nodules in thoracic surgery. This systematic review and meta-analysis aimed to evaluate the efficacy and safety of preoperative bronchoscopic marking. METHODS: The PubMed and Cochrane Library databases were searched for clinical studies evaluating preoperative bronchoscopic marking for pulmonary resection. Non-comparative and random effects model-based meta-analyses were conducted to calculate the pooled success and complication rates of bronchoscopic marking. RESULTS: Twenty-five eligible studies were included. Among these, 15 studies conducted dye marking under electromagnetic navigation bronchoscopy, 4 used virtual-assisted lung mapping and 7 used other marking methods. The overall pooled successful marking rate, successful resection rate and complete resection rate were 0.97 [95% confidence interval (CI) 0.95-0.99], 0.98 (95% CI 0.96-1.00) and 1.00 (95% CI 1.00-1.00), respectively. The overall pooled rates of pleural injury and pulmonary haemorrhage were 0.02 (95% CI 0.01-0.05) and 0.00 (95% CI 0.00-0.00), respectively. CONCLUSIONS: This meta-analysis demonstrated that bronchoscopic marking is very safe and effective. Bronchoscopic marking should be considered, especially if there are concerns about the safety of other localization methods.
OBJECTIVES: Recent studies have suggested the usefulness of preoperative bronchoscopic marking techniques for the localization of pulmonary nodules in thoracic surgery. This systematic review and meta-analysis aimed to evaluate the efficacy and safety of preoperative bronchoscopic marking. METHODS: The PubMed and Cochrane Library databases were searched for clinical studies evaluating preoperative bronchoscopic marking for pulmonary resection. Non-comparative and random effects model-based meta-analyses were conducted to calculate the pooled success and complication rates of bronchoscopic marking. RESULTS: Twenty-five eligible studies were included. Among these, 15 studies conducted dye marking under electromagnetic navigation bronchoscopy, 4 used virtual-assisted lung mapping and 7 used other marking methods. The overall pooled successful marking rate, successful resection rate and complete resection rate were 0.97 [95% confidence interval (CI) 0.95-0.99], 0.98 (95% CI 0.96-1.00) and 1.00 (95% CI 1.00-1.00), respectively. The overall pooled rates of pleural injury and pulmonary haemorrhage were 0.02 (95% CI 0.01-0.05) and 0.00 (95% CI 0.00-0.00), respectively. CONCLUSIONS: This meta-analysis demonstrated that bronchoscopic marking is very safe and effective. Bronchoscopic marking should be considered, especially if there are concerns about the safety of other localization methods.