C110-15 Saline Tract Sealing to Prevent Pneumothorax and Chest Tube Placement After CT-Guided Lung Biopsy: A Systematic Review and Meta-Analysis

Rationale Pneumothorax is the most common complication of CT-guided lung biopsy, occurring in 25% of cases, with 5-6% requiring chest tube placement. Tract-sealing techniques such as autologous blood, fibrin glue, and collagen plugs can reduce this risk but are costly or may cause local reactions. Saline sealing is an inexpensive and widely available alternative, but evidence of its effectiveness is limited. Methods We performed a systematic review and meta-analysis of RCTs and comparative cohort studies including adults undergoing CT-guided percutaneous lung biopsy, following PRISMA guidelines. The intervention was immediate instillation of sterile saline into the biopsy tract, compared with no sealing or placebo. Outcomes analyzed were post-biopsy pneumothorax and chest tube placement, respectively. Statistical analysis was performed using Review Manager 5.4 (Cochrane Collaboration). Results Seven studies (1455 patients; 680 saline) were included. Saline volumes ranged from 1-10 mL, needle gauges 16-20G, and follow-up imaging was performed within hours. Saline tract sealing significantly reduced pneumothorax (RR 0.46; 95% CI 0.35-0.61; p < 0.00001; I² = 50%) and chest tube placement (RR 0.22; 95% CI 0.12-0.42; p < 0.00001; I² = 0%). Conclusions Saline tract sealing effectively reduces pneumothorax and chest tube placement after CT-guided lung biopsy. Its simplicity, safety, low cost, and wide availability make it a practical strategy to improve procedural safety. This abstract is funded by: None