Skip to main content

Main menu

  • Home
  • Current issue
  • Past issues
  • Authors/reviewers
    • Instructions for authors
    • Submit a manuscript
    • COVID-19 submission information
    • Institutional open access agreements
    • Peer reviewer login
  • Alerts
  • Subscriptions
  • ERS Publications
    • European Respiratory Journal
    • ERJ Open Research
    • European Respiratory Review
    • Breathe
    • ERS Books
    • ERS publications home

User menu

  • Log in
  • Subscribe
  • Contact Us
  • My Cart

Search

  • Advanced search
  • ERS Publications
    • European Respiratory Journal
    • ERJ Open Research
    • European Respiratory Review
    • Breathe
    • ERS Books
    • ERS publications home

Login

European Respiratory Society

Advanced Search

  • Home
  • Current issue
  • Past issues
  • Authors/reviewers
    • Instructions for authors
    • Submit a manuscript
    • COVID-19 submission information
    • Institutional open access agreements
    • Peer reviewer login
  • Alerts
  • Subscriptions

Sensitivity and complications of thoracentesis and thoracoscopy: a meta-analysis

Gabriela Martinez-Zayas, Sofia Molina, David E. Ost
European Respiratory Review 2022 31: 220053; DOI: 10.1183/16000617.0053-2022
Gabriela Martinez-Zayas
Department of Pulmonary Medicine, The University of Texas MD Anderson Cancer Centre, Houston, TX, USA
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Sofia Molina
Department of Pulmonary Medicine, The University of Texas MD Anderson Cancer Centre, Houston, TX, USA
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
David E. Ost
Department of Pulmonary Medicine, The University of Texas MD Anderson Cancer Centre, Houston, TX, USA
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • For correspondence: dost@mdanderson.org
  • Article
  • Figures & Data
  • Info & Metrics
  • PDF
Loading

Figures

  • Tables
  • Supplementary Materials
  • FIGURE 1
    • Download figure
    • Open in new tab
    • Download powerpoint
    FIGURE 1

    Study selection algorithm. Results of search and study selection algorithm for sensitivity and complication rates of a) thoracentesis and b) thoracoscopy.

  • FIGURE 2
    • Download figure
    • Open in new tab
    • Download powerpoint
    FIGURE 2

    Forest plot: sensitivity of thoracentesis. Pooled estimate for sensitivity (ES) of thoracentesis for malignant pleural effusion secondary to any malignancy. TP: true positives; FN: false negatives.

  • FIGURE 3
    • Download figure
    • Open in new tab
    • Download powerpoint
    FIGURE 3

    Forest plots: sensitivity of thoracentesis by cancer type. Sensitivity of thoracentesis for malignant pleural effusion secondary to a) mesothelioma, b) lung cancer and c) breast cancer. ES: estimated sensitivity; TP: true positives; FN: false negatives.

  • FIGURE 4
    • Download figure
    • Open in new tab
    • Download powerpoint
    FIGURE 4

    Forest plot: sensitivity of thoracoscopy for malignant pleural effusion secondary to any malignancy. ES: estimated sensitivity; TP: true positives; FN: false negatives.

  • FIGURE 5
    • Download figure
    • Open in new tab
    • Download powerpoint
    FIGURE 5

    Forest plot: sensitivity of thoracoscopy by cancer type. Sensitivity of thoracoscopy for malignant pleural effusion secondary to mesothelioma. ES: estimated sensitivity; TP: true positives; FN: false negatives.

Tables

  • Figures
  • Supplementary Materials
  • TABLE 1

    Meta-analyses for sensitivity of thoracentesis and thoracoscopy

    Studies (n)Patients in the studies (n)Patients included in the sensitivity analysis (n)Pooled sensitivity (95% CI)I2 statistic# (%)Within-strata heterogeneity p-valuesROC-AUC (95% CI)Test of heterogeneity between groups¶ p-valueMeta-regression¶ p-value
    Thoracentesis
     Primary meta-analysis of sensitivity for MPE secondary to any malignancy2911 95254440.643 (0.592–0.692)92.302<0.0010.85 (0.82–0.88)
      Year of publication0.779
      Prevalence of MPE0.820
     Secondary meta-analysis of sensitivity for MPE secondary to mesothelioma8856511330.451 (0.249–0.661)97.52<0.0010.86 (0.82–0.89)
     Secondary meta-analysis of sensitivity for MPE secondary to lung cancer12626711840.738 (0.648–0.819)89.505<0.0010.99 (0.97–0.99)
     Secondary meta-analysis of sensitivity for MPE secondary to breast cancer956205320.820 (0.700–0.917)88.668<0.0011.0 (0.98–1.00)
    Thoracoscopy
     Primary meta-analysis of sensitivity for MPE secondary to any malignancy41565229630.929 (0.905–0.95)75.79<0.0010.99 (0.98–1.00)
      Year of publication0.510
      Prevalence of MPE0.753
      Thoracoscope used0.824
       Rigid2126660.929 (0.908–0.948)41.800.024
       Semi-rigid1525210.931 (0.88–0.971)84.88<0.001
       Rigid and semi-rigid43480.906 (0.819–0.969)63.900.040
      Anaesthesia used0.928
       General anaesthesia32400.917(0.735–1.00)<0.001
       Local anaesthesia45680.931 (0.905–0.954)76.34<0.001
       General and local anaesthesia3448440.920 (0.879–0.954)28.89<0.001
     Secondary meta-analysis of sensitivity for MPE secondary to mesothelioma1514004530.915 (0.871–0.952)48.790.0170.90 (0.94–0.97
     Secondary meta-analysis of sensitivity for MPE secondary to lung cancer+148
     Secondary meta-analysis of sensitivity for MPE secondary to breast cancer+

    Sensitivities are reported by patient. sROC: summary receiver operating characteristic; AUC: area under the curve; MPE: malignant pleural effusions. #: the I2 statistic describes the percentage of total variation across studies due to heterogeneity between studies rather than chance. A value >75% is considered as major heterogeneity and a value <40% is considered insufficient to prove heterogeneity [19]; ¶: causes of heterogeneity between groups and meta-regressions are only reported for the combined analysis given the very few studies included in the stratified analysis that limit the power of the tests; +: a pooled estimate could not be calculated given that only one study with >10 patients with MPE reported sensitivity of thoracoscopy for MPE secondary to lung cancer and breast cancer.

    • TABLE 2

      Meta-analysis results for complication rate of thoracentesis and thoracoscopy, and pneumothorax rate of thoracentesis

      Studies (n)Procedures (n)Pool-complication rate (95% CI)I2 statistic (%)#Within-study heterogeneity p-valueTest of heterogeneity within groups (p-value)Meta-regression p-value
      Thoracentesis
       Complication rate23328630.041 (0.025–0.061)97.318<0.001
        Year of publication0.174
       Pneumothorax rate36663590.025 (0.017–0.034)96.070<0.001
        Year of publication0.855
       Complications other than pneumothorax22325780.015 (0.009–0.023)89.55<0.001
        Year of publication0.137
      Thoracoscopy
       Complication rate per procedure79151390.040 (0.029–0.052)85.910<0.001
        Year of publication0.116
        Thoracoscope used0.992
         Rigid3328620.042 (0.023–0.066)83.86<0.001
         Semi-rigid3032310.040 (0.020–0.064)84.79<0.001
         Rigid and semi-rigid918310.043 (0.01–0.091)92.29<0.001
        Anaesthesia used0.150
         General anaesthesia129690.016 (0.001–0.042)73.87<0.001
         Local anaesthesia6372580.045 (0.031–0.061)86.00<0.001
         General and local anaesthesia22110.054 (0.025–0.090)<0.001

      All complications are reported by procedure. Meta-regression on prevalence was not made given that most studies reporting complications did not report results on sensitivity and prevalence of malignant pleural effusion. #: the I2 statistic describes the percentage of total variation across studies due to heterogeneity between studies rather than chance. A value >75% is considered as major heterogeneity and a value <40% is considered insufficient to prove heterogeneity [19].

      Supplementary Materials

      • Figures
      • Tables
      • Supplementary Material

        Please note: supplementary material is not edited by the Editorial Office, and is uploaded as it has been supplied by the author.

        Supplementary material ERR-0053-2022.SUPPLEMENT

      PreviousNext
      Back to top
      View this article with LENS
      Vol 31 Issue 166 Table of Contents
      European Respiratory Review: 31 (166)
      • Table of Contents
      • Index by author
      Email

      Thank you for your interest in spreading the word on European Respiratory Society .

      NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

      Enter multiple addresses on separate lines or separate them with commas.
      Sensitivity and complications of thoracentesis and thoracoscopy: a meta-analysis
      (Your Name) has sent you a message from European Respiratory Society
      (Your Name) thought you would like to see the European Respiratory Society web site.
      CAPTCHA
      This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
      Print
      Citation Tools
      Sensitivity and complications of thoracentesis and thoracoscopy: a meta-analysis
      Gabriela Martinez-Zayas, Sofia Molina, David E. Ost
      European Respiratory Review Dec 2022, 31 (166) 220053; DOI: 10.1183/16000617.0053-2022

      Citation Manager Formats

      • BibTeX
      • Bookends
      • EasyBib
      • EndNote (tagged)
      • EndNote 8 (xml)
      • Medlars
      • Mendeley
      • Papers
      • RefWorks Tagged
      • Ref Manager
      • RIS
      • Zotero

      Share
      Sensitivity and complications of thoracentesis and thoracoscopy: a meta-analysis
      Gabriela Martinez-Zayas, Sofia Molina, David E. Ost
      European Respiratory Review Dec 2022, 31 (166) 220053; DOI: 10.1183/16000617.0053-2022
      del.icio.us logo Digg logo Reddit logo Technorati logo Twitter logo CiteULike logo Connotea logo Facebook logo Google logo Mendeley logo
      Full Text (PDF)

      Jump To

      • Article
        • Abstract
        • Abstract
        • Introduction
        • Methods
        • Results
        • Discussion
        • Supplementary material
        • Footnotes
        • References
      • Figures & Data
      • Info & Metrics
      • PDF

      Subjects

      • Lung cancer
      • Respiratory clinical practice
      • Tweet Widget
      • Facebook Like
      • Google Plus One

      More in this TOC Section

      • Confocal laser endomicroscopy in pulmonary medicine
      • Mucolytics for acute exacerbations of COPD: a meta-analysis
      • Targeting IL-33 and TSLP pathways for novel pulmonary therapeutics
      Show more Reviews

      Related Articles

      Navigate

      • Home
      • Current issue
      • Archive

      About the ERR

      • Journal information
      • Editorial board
      • Reviewers
      • Press
      • Permissions and reprints
      • Advertising
      • Sponsorship

      The European Respiratory Society

      • Society home
      • myERS
      • Privacy policy
      • Accessibility

      ERS publications

      • European Respiratory Journal
      • ERJ Open Research
      • European Respiratory Review
      • Breathe
      • ERS books online
      • ERS Bookshop

      Help

      • Feedback

      For authors

      • Instructions for authors
      • Publication ethics and malpractice
      • Submit a manuscript

      For readers

      • Alerts
      • Subjects
      • RSS

      Subscriptions

      • Accessing the ERS publications

      Contact us

      European Respiratory Society
      442 Glossop Road
      Sheffield S10 2PX
      United Kingdom
      Tel: +44 114 2672860
      Email: journals@ersnet.org

      ISSN

      Print ISSN: 0905-9180
      Online ISSN: 1600-0617

      Copyright © 2023 by the European Respiratory Society