Robotic-assisted transbronchial biopsy versus computed tomography-guided transthoracic needle biopsy for peripheral pulmonary lesions: a systematic review and meta-analysis of direct comparative studies.
Atef A Hassan, Mohamed Mostafa El Sheikh, Amr A Hassan et al.
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In 30 seconds
This systematic review and meta-analysis compared robotic-assisted bronchoscopy (RAB) and computed tomography-guided transthoracic biopsy (CTTB) for peripheral pulmonary lesions in adults. The analysis included five retrospective studies, revealing comparable diagnostic yields (risk ratio 0.99) but significantly fewer pneumothorax complications with RAB (risk ratio 0.25).
Key findings
- Diagnostic yield was comparable between RAB and CTTB (RR 0.99, 95% CI 0.93-1.06).
- Pneumothorax requiring intervention was significantly less frequent with RAB (RR 0.25, 95% CI 0.14-0.46).
- RAB took approximately 50 minutes longer than CTTB when including endobronchial ultrasound.
- Certainty of evidence for pleural complications was low, and very low for other outcomes.
Why it matters
Understanding the comparative safety and efficacy of RAB and CTTB is crucial for clinicians managing peripheral pulmonary lesions, as it informs decision-making regarding biopsy techniques and patient safety.
What to keep in mind
All studies were retrospective and conducted within a single health system, limiting generalizability and the ability to stratify results by lesion characteristics.