Sullivan Katrina J, Li Michelle, Haworth Sarah, Chernetsova Elizabeth, Wayne Carolyn, Kapralik Jessica, Chan Emily, Nasr Ahmed
Department of Pediatric Surgery, Children's Hospital of Eastern Ontario, 401 Smyth Road, Ottawa, ON, K1H 8L1, Canada.
Department of Pathology and Laboratory Medicine, University of Ottawa, 451 Smyth Road, Ottawa, ON, K1H 8M5, Canada.
Pediatr Surg Int. 2017 Jun;33(6):665-675. doi: 10.1007/s00383-017-4079-2. Epub 2017 Mar 14.
Controversy exists on the optimal age for elective resection of asymptomatic congenital pulmonary airway malformation. Current recommendations vary widely, highlighting the overall lack of consensus. A systematic search of Embase, MEDLINE, CINAL, and CENTRAL was conducted in January 2016. Identified citations were screening independently in duplicate and consensus was required for inclusion. Results were pooled using inverse variance fixed effects meta-analysis. Meta-analysis results indicate no statistically significant differences for complications within the 3-month and 6-month age comparison groups [odds ratio (OR) 4.20, 95% confidence interval (CI) 0.78-22.77, I = 0%; OR 2.39, 95% CI 0.63-9.11, I = 0%, respectively]. Older patients were significantly favoured for 3-month and 6-month age comparison groups for length of hospital stay [mean difference (MD) 4.13, 95% CI 2.31-5.96, I = 0%; MD 3.38, 95% CI 0.44-6.31, I = 0%, respectively]. Borderline statistical significance was observed for chest tube duration in patients ≥6 months of age (MD 1.06, 95% CI 0.02-2.09, I = 0%). No mortalities were recorded. Surgical treatment appears to be safe at all ages, with no mortalities and similar rates of complications between age groups. The included evidence was not sufficient to make a conclusive recommendation on optimal age for elective resection.
对于无症状先天性肺气道畸形择期切除的最佳年龄存在争议。目前的建议差异很大，这突出表明总体上缺乏共识。2016年1月对Embase、MEDLINE、CINAL和CENTRAL进行了系统检索。对识别出的文献进行独立的重复筛选，纳入需要达成共识。使用逆方差固定效应荟萃分析汇总结果。荟萃分析结果表明，3个月和6个月年龄比较组的并发症在统计学上无显著差异[优势比（OR）4.20，95%置信区间（CI）0.78 - 22.77，I² = 0%；OR 2.39，95% CI 0.63 - 9.11，I² = 0%，分别]。在3个月和6个月年龄比较组中，老年患者在住院时间方面明显占优[平均差（MD）4.13，95% CI 2.31 - 5.96，I² = 0%；MD 3.38，95% CI 0.44 - 6.31，I² = 0%，分别]。在≥6个月龄的患者中，胸管留置时间观察到边缘统计学显著性（MD 1.06，95% CI 0.02 - 2.09，I² = 0%）。未记录到死亡病例。手术治疗在所有年龄似乎都是安全的，各年龄组之间无死亡病例且并发症发生率相似。纳入的证据不足以就择期切除的最佳年龄给出确凿建议。
