Comparative efficacy and safety of electromagnetic navigation bronchoscopy localization and CT- guided percutaneous localization in thoracoscopic resection of pulmonary nodules: a systematic review and meta-analysis

Abstract

Abstract Objectives This study was designed to evaluate the efficacy and safety between electromagnetic navigation bronchoscopy (ENB) and CT-guided percutaneous localization prior to resection of pulmonary nodules. Methods Pubmed, Embase, Web of science, and the Cochrane library databases were searched from January 2000 to April 2022 for relevant studies. The primary outcome was the success rate, and the secondary outcomes were the pneumothorax rates and localization time. The meta-analysis was performed by Review Manager 5.4. Results Four cohort studies comprising 366 patients (ENB group: 160, CT group: 206) were analyzed. Compared with the CT-guided group, the ENB-guided group was associated with lower pneumothorax rates (relative ratio [RR] = 0.16, 95% CI 0.04–0.65, P = 0.01). No significant differences were found in success rates (relative ratio [RR] = 1.02, 95% confidence interval [CI] 0.99–1.05, P = 0.21) and localization time (mean difference [MD] = 0.99, 95% CI -5.73-7.71, P = 0.77) between the ENB- and CT-guided groups. Conclusions ENB-guided localization has huge prospects as a preoperative marking technique before pulmonary nodule resection.