Wu Yuhao, Wu Zhichao, Zheng Junmeng, Li Yonggang, Zhou Yuehang, Kuang Hongyu, Jin Xin, Wu Chun
Department of Cardiothoracic Surgery, Children's Hospital of Chongqing Medical University, No.136 Zhongshan Second Road, Yuzhong District, Chongqing, 400014, China.
Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, 400014, China.
J Cardiothorac Surg. 2018 Jun 15;13(1):69. doi: 10.1186/s13019-018-0756-z.
A meta-analysis was performed to compare the differences in outcomes between sutureless technique and conventional surgery for primary repair of Total Anomalous Pulmonary Venous Connection(TAPVC).
Electronic databases, including PubMed, EMbase, Medline, CNKI, Wanfang Data and Weipu Data were searched systematically for the literature aimed mainly at comparing the therapeutic effects for primary repair of TAPVC administered by sutureless technique and conventional surgery. Corresponding data sets were extracted and two reviewers independently assessed the methodological quality.
Seven studies meeting the inclusion criteria were included, involving a total of 1293 subjects. It was observed that sutureless technique entailed a lower occurrence rate of post-operative Pulmonary Veins Obstruction (PVO) (OR, 0.52 95%CI, 0.32-0.86; P = 0.01) and re-operation due to PVO (OR, 0.28;95%CI, 0.09-0.87; P = 0.03). However, meta-analyses of hospitalization time (WMD, 5.92; 95%CI, - 7.97-19.80; P = 0.40) and post-operative mortality (OR, 0.65; 95%CI, 0.41-1.04; P = 0.07) showed no significant differences between sutureless technique and conventional surgery. Meta-analysis of Cardiopulmonary Bypass (CPB) time and aortic cross-clamp time also showed no significant differences between the two surgical approaches (WMD, 5.07; 95%CI, - 9.29-19.42; P = 0.49); (WMD, 5.73; 95%CI, - 7.76-19.23; P = 0.40), but the result remained inconclusive due to pooling result changes after sensitivity analysis.
Compared with conventional surgery, a lower occurrence rate of post-operative PVO and re-operation due to PVO were associated with sutureless technique. Meanwhile, hospitalization time and post-operative mortality were not statistically different between the two surgical approaches. Pooling result of CPB and aortic cross-clamp time between the two groups remained inconclusive.
进行一项荟萃分析，比较在完全性肺静脉异位连接（TAPVC）一期修复中，无缝合技术与传统手术在治疗效果上的差异。
系统检索电子数据库，包括PubMed、EMbase、Medline、中国知网、万方数据和维普数据，查找主要比较无缝合技术与传统手术对TAPVC一期修复治疗效果的文献。提取相应数据集，两名评价者独立评估方法学质量。
纳入7项符合纳入标准的研究，共涉及1293例受试者。结果显示，无缝合技术术后肺静脉梗阻（PVO）发生率较低（OR，0.52；95%CI，0.32 - 0.86；P = 0.01），因PVO再次手术的发生率也较低（OR，0.28；95%CI，0.09 - 0.87；P = 0.03）。然而，住院时间的荟萃分析（WMD，5.92；95%CI， - 7.97 - 19.80；P = 0.40）和术后死亡率的荟萃分析（OR，0.65；95%CI，0.41 - 1.04；P = 0.07）表明，无缝合技术与传统手术之间无显著差异。体外循环（CPB）时间和主动脉阻断时间的荟萃分析也显示，两种手术方式之间无显著差异（WMD，5.07；95%CI， - 9.29 - 19.42；P = 0.49）；（WMD，5.73；95%CI， - 7.76 - 19.23；P = 0.40），但由于敏感性分析后合并结果改变，结果仍不确定。
与传统手术相比，无缝合技术术后PVO发生率及因PVO再次手术的发生率较低。同时，两种手术方式在住院时间和术后死亡率方面无统计学差异。两组CPB和主动脉阻断时间的合并结果仍不确定。
