{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,13]],"date-time":"2026-11-13T13:19:15Z","timestamp":1794575955936,"version":"4.9.1"},"reference-count":49,"publisher":"Oxford University Press (OUP)","issue":"1108","license":[{"start":{"date-parts":[[2020,1,3]],"date-time":"2020-01-03T00:00:00Z","timestamp":1578009600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,1,3]]},"abstract":"<jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>This systematic review and meta-analysis investigated risk factors for pneumothorax following CT-guided percutaneous transthoracic lung biopsy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A systematic search of nine literature databases between inception to September 2019 for eligible studies was performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>36 articles were included with 23,104 patients. The overall pooled incidence for pneumothorax was 25.9% and chest drain insertion was 6.9%. Pneumothorax risk was significantly reduced in the lateral decubitus position where the biopsied lung was dependent compared to a prone or supine position [odds ratio (OR):3.15]. In contrast, pneumothorax rates were significantly increased in the lateral decubitus position where the biopsied lung was non-dependent compared to supine (OR:2.28) or prone position (OR:3.20). Other risk factors for pneumothorax included puncture site up compared to down through a purpose-built biopsy window in the CT table (OR:4.79), larger calibre guide\/needles (\u226418G vs &amp;gt;18G: OR 1.55), fissure crossed (OR:3.75), bulla crossed (OR:6.13), multiple pleural punctures (&amp;gt;1 vs 1: OR:2.43), multiple non-coaxial tissue sample (&amp;gt;1 vs 1: OR 1.99), emphysematous lungs (OR:3.33), smaller lesions (&amp;lt;4\u2009cm vs 4\u2009cm: OR:2.09), lesions without pleural contact (OR:1.73) and deeper lesions (\u22653\u2009cm vs &amp;lt;3cm: OR:2.38).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>This meta-analysis quantifies factors that alter pneumothorax rates, particularly with patient positioning, when planning and performing a CT-guided lung biopsy to reduce pneumothorax rates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Advances in knowledge:<\/jats:title>\n                    <jats:p>Positioning patients in lateral decubitus with the biopsied lung dependent, puncture site down with a biopsy window in the CT table, using smaller calibre needles and using coaxial technique if multiple samples are needed are associated with a reduced incidence of pneumothorax.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1259\/bjr.20190866","type":"journal-article","created":{"date-parts":[[2019,12,20]],"date-time":"2019-12-20T13:01:46Z","timestamp":1576846906000},"source":"Crossref","is-referenced-by-count":221,"title":["Pneumothorax rates in CT-Guided lung biopsies: a comprehensive systematic review and meta-analysis of risk factors"],"prefix":"10.1093","volume":"93","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6282-7677","authenticated-orcid":false,"given":"Ya Ruth","family":"Huo","sequence":"first","affiliation":[{"name":"Bankstown-Campbelltown Hospital, South Western Sydney Clinical School, University of New South Wales , Sydney , Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael Vinchill","family":"Chan","sequence":"additional","affiliation":[{"name":"Department of Radiology, Concord Repatriation General Hospital , Sydney , Australia"},{"name":"University of Sydney, Faculty of Medicine , Sydney , Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Al-Rahim","family":"Habib","sequence":"additional","affiliation":[{"name":"University of Sydney, Faculty of Medicine , Sydney , Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isaac","family":"Lui","sequence":"additional","affiliation":[{"name":"Department of Radiology, Concord Repatriation General Hospital , Sydney , Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lloyd","family":"Ridley","sequence":"additional","affiliation":[{"name":"Department of Radiology, Concord Repatriation General Hospital , 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