Yao Xiangwen,Wang Chengqian,Lei Yiming,et al.Meta-analysis of the efficacy of video-assisted thoracoscopic surgery versus thoracotomy for pulmonary sequestration in children[J].Journal of Clinical Pediatric Surgery,2025,(07):675-682.[doi:10.3760/cma.j.cn101785-202407040-014]
电视胸腔镜手术和开胸手术治疗儿童肺隔离症疗效的Meta分析
- Title:
- Meta-analysis of the efficacy of video-assisted thoracoscopic surgery versus thoracotomy for pulmonary sequestration in children
- Keywords:
- Bronchopulmonary Sequestration; VATS; Meta Analysis; Surgical Procedures; Operative; Child
- 摘要:
- 目的 手术是治疗儿童肺隔离症最有效的方法之一,目前常用的手术方式包括开胸手术和电视辅助胸腔镜手术(video-assisted thoracoscopic surgery,VATS)。本研究通过对VATS和开胸的手术效果进行Meta分析,以评价VATS治疗儿童肺隔离症的有效性和安全性。方法 检索PubMed、Web of Science、Cochrane Library、Embase、中国知网、万方医学网、维普数据库中关于VATS与开胸治疗儿童肺隔离症的相关研究,检索时间为数据库建立之日至2024年7月;从手术时间、术中出血量、术后胸腔引流管留置时间、术后胸腔引流量、术后并发症及住院时间等方面进行对比分析。结果 本Meta分析纳入了6项回顾性研究,与开胸组相比,VATS手术时间[MD=-10.07,95%CI(-25.56,5.41),P=0.20]、术中出血量[MD=-33.47,95%CI(-63.19,-3.75),P=0.03]、术后胸腔引流管留置时间[MD=-2.05,95%CI(-2.68,-1.42),P＜0.00001]、术后胸腔引流管引流量[MD=-56.41,95%CI(-102.43,-10.40),P=0.02]、术后并发症[OR=0.39,95%CI(0.15,1.05),P=0.06]、术后住院时间[MD=-3.83,95%CI(-5.68,-1.98),P＜0.0001]。结论 VATS和开胸均为治疗儿童肺隔离症的有效术式,基于本Meta分析结果可以得出VATS是一种更先进、更安全的术式,比开胸更适合用于治疗儿童肺隔离症。
- Abstract:
- Objective Surgery has been one of the most effective treatments for pulmonary sequestration (PS) in children.Currently two commonly used surgical approaches are thoracotomy and video-assisted thoracoscopic surgery (VATS).A meta-analysis was conducted by comparing the surgical outcomes of VATS versus thoracotomy for evaluate the effectiveness and safety of VATS in treating pediatric PS. Methods The databases of PubMed,Web of Science,Cochrane Library and Embase were searched.Original researches on the correlation between VATS and thoracotomy for pediatric PS were compared and analyzed from the aspects of operative duration,intraoperative volume of blood loss,postoperative thoracic tube retention time,postoperative thoracic drainage volume,postoperative complications and hospitalization stay. Results The results of meta-analysis included 6 original cohort studies.As compared with thoracotomy group,VATS operative duration[MD=-10.07,95%CI(-25.56,5.41),P=0.20],intraoperative volume of blood loss[MD=-33.47,95%CI(-63.19,-3.75),P=0.03],postoperative thoracic tube retention time[MD=-2.05,95%CI(-2.68,-1.42),P<0.00001],postoperative thoracic tube drainage volume[MD=-56.41,95%CI(-102.43,-10.40),P=0.02],postoperative complications[OR=0.39,95%CI(0.15,1.05),P=0.02]and postoperative hospitalization stay[MD=-3.83,95%CI(-5.68,-1.98),P<0.0001]. Conclusions Both VATS and thoracotomy are effective surgical approaches for treating pediatric PS.Based upon the results of this meta-analysis,VATS is a more advanced and safer option so that it is preferred for pediatric PS.
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备注/Memo
收稿日期:2024-7-17。
基金项目:烟台市科技计划项目(2022YD038)
通讯作者:王威,Email:wangweitxzz@163.com