Impact Of Sedation Type On The Dignostic Yield Of EBUS-TBNA:A Meta-analysis

Background: Endobronchial ultrasound-guided transbrochial needle aspiration(EBUS-TBNA)has become an important tool in the diagnosis for mediastinal lymph node lesions.Adequate sedation plays important role in the procedure of EBUS-TBNA.However,a few of studies have reported the impact of sedation types on the diagnostic yield for EBUS-TBNA.We performed the present Meta-analysis to investigate the difference of EBUS-TBNA diagnostic yields between deep sedation(DS)and moderate sedation(DS).Method: We searched the databases of PubMed,Embase,Cochrane library,CNKI,and VIP until May 2019.Studies reporting the comparison of deep sedation and moderate sedation for EBUS-TBNA diagnostic yields were identified.The overall diagnostic yields,lymph node size,procedure time,and the complication rates were evaluated in the Meta analysis.Result: Seven studies involving 2408 patients were finally included in our analysis.The pooled OR(95% CI)for the overall diagnostic yield of EBUS-TBNA was 1.20(0.98-1.46),respectively,suggesting no statically significant difference between DS and MS groups.For the procedure time,the pooled SMD(95%CI)was 0.49(0.21-0.76,p=0.0005),indicating that the longer procedure duration of DS group than the MS group.Besides,no difference was observed for the lymph node size,the number of lymph node sampling,and the complication rates between the comparable groups.SMD(95%CI):-0.28(-0.70-0.14,p=0.19);0.20(-0.77-1.16,p=0.69),OR(95%CI): 0.62(0.20-1.91,p=0.40).The Funnel plot,the Eggers test,and the Begg test suggested no publication bias?Conclusion: The diagnostic yields of EBUS-TBNA operated in deep sedation or moderate sedation had no statically significant difference.The procedure time in the deep sedation group was longer than the moderate sedation group.However,for the lymph node size,lymph node samples per patient,and the complication rates,no statically significance was observed in our analysis.