Utility and safety of endobronchial ultrasound‑guided transbronchial mediastinal cryobiopsy (EBUS-TMC): A systematic review and meta‑analysis.

Background: Modalities to improve tissue acquisition during endobronchial ultrasound‑guided transbronchial needle aspiration (EBUS‑TBNA) have been investigated. Endobronchial ultrasound‑guided transbronchial mediastinal cryobiopsy (EBUS‑TMC) is a modality to obtain larger histological samples by inserting a cryoprobe into the mediastinal lesion. We aimed to study the diagnostic yield and safety of EBUS‑TMC. Methods: We performed a systematic search of the PubMed and Embase databases to extract the relevant studies. We then performed a meta‑analysis to calculate the diagnostic yield of EBUS‑TMC and compare it with EBUS‑TBNA. Results: Following a systematic search, we identified 14 relevant studies (869 patients undergoing EBUS‑TMC and EBUS‑TBNA). We then performed a meta‑analysis of the diagnostic yield of EBUS‑TMC and EBUS‑TBNA from studies wherein both procedures were performed. The pooled diagnostic yield of EBUS‑TMC was 92% (95% confidence interval [CI], 89%–95%). The pooled diagnostic yield of EBUS‑TBNA was 81% (95% CI, 77%–85%). The risk difference in yield was 11% (95% CI, 6%–15%, I 2 = 0%) when EBUS‑TMC and EBUS‑TBNA were compared. The only complication reported commonly with EBUS‑TMC was minor bleeding. The complication rate was comparable with EBUS‑TBNA. Conclusion: EBUS‑TMC provides a greater diagnostic yield with a similar risk of adverse events compared to EBUS‑TBNA. Future studies are required to clearly establish which patients are most likely to benefit from this modality. [ABSTRACT FROM AUTHOR]