Silva Gracilene Pinheiro, Cataneo Daniele Cristina, Cataneo Antonio Jose Maria
Fellow Master degree, Postgraduate Program in Medicine, Botucatu School of Medicine, Universidade Estadual Paulista (UNESP), Botucatu-SP, Brazil. Conception and design of the study, acquisition of data, manuscript preparation.
Associate Professor, Department of Surgery, Botucatu School of Medicine, UNESP, Botucatu-SP, Brazil. Conception and design of the study, acquisition of data, manuscript writing.
Acta Cir Bras. 2018 Jan;33(1):49-66. doi: 10.1590/s0102-865020180010000006.
To evaluate the most used approach to treat traumatic diaphragmatic ruptures, and in which one the requirement to assess the second cavity is more frequent.
Systematic review, observational studies. Outcomes: moment of approach, most commonly via addressed and the requirement to open the other cavity. Bases searched: Lilacs, Pubmed, Embase, Clinicaltrials.gov and Web of Science. Statistical analysis: StatsDirect 3.0.121 software.
Sixty eight studies (2023 participants) were included. Approach in acute phase was performed four times more than in chronic phase. Approach: abdominal 65% (IC 95% 63-67%), thoracic 23% (IC 95% 21-24%), abdominal in the acute phase 75% (IC 95% 71-78%), and chronic 24% (IC 95% 19-29%), thoracic in the acute phase 12% (IC 95% 10-14%) and chronic 69% (IC 95% 63-74%). Thorax opening in the abdominal approach: 10% (95% CI 8-14%). Abdomen opening in the thoracic approach: 15% (95% CI 7-24%).
The most common approach was the abdominal. The approach in the acute phase was more common. In the acute phase the abdominal approach is more frequent than the thoracic approach. In the chronic phase the thoracic approach is more frequent than the abdominal one. The requirement to open the second cavity was similar in both approaches.
评估治疗创伤性膈肌破裂最常用的方法，以及哪种方法中评估第二腔的需求更频繁。
系统评价，观察性研究。结果：手术时机、最常用的途径以及打开另一腔的需求。检索数据库：Lilacs、Pubmed、Embase、Clinicaltrials.gov和科学网。统计分析：StatsDirect 3.0.121软件。
纳入68项研究（2023名参与者）。急性期手术次数是慢性期的四倍。手术途径：经腹65%（95%置信区间63-67%），经胸23%（95%置信区间21-24%），急性期经腹75%（95%置信区间71-78%），慢性期24%（95%置信区间19-29%），急性期经胸12%（95%置信区间10-14%），慢性期69%（95%置信区间63-74%）。经腹手术中打开胸腔的比例：10%（95%置信区间8-14%）。经胸手术中打开腹腔的比例：15%（95%置信区间7-24%）。
最常用的途径是经腹。急性期手术更常见。急性期经腹手术比经胸手术更频繁。慢性期经胸手术比经腹手术更频繁。两种手术途径中打开第二腔的需求相似。
