Lu Jun, Zhao Hongmou, Liang Xiaojun, Ma Qiang
Associate Chief Physician, Department of Foot and Ankle Surgery, Xi'an Jiao Tong University-Affiliated Honghui Hospital, Xi'an, China.
Chief Physician, Department of Foot and Ankle Surgery, Xi'an Jiao Tong University-Affiliated Honghui Hospital, Xi'an, China.
J Foot Ankle Surg. 2020 Jul-Aug;59(4):801-806. doi: 10.1053/j.jfas.2019.03.021.
This meta-analysis aimed to compare the clinical outcomes of minimally invasive surgery (MIS) and traditional open surgery for the correction of symptomatic hallux valgus. A literature search was conducted, and a total of 11 studies with 1166 (52.98%, cases) patients treated with MIS and 1035 (47.02%, cases) patients treated with traditionally open surgery were included in the meta-analyses. The pooled data (odds ratio [OR] 6.28, 95% confidence interval [CI] 3.20 to 12.32, Z = 5.35, p < .01) indicated that patients treated with MIS had a significantly higher rate of excellent-good radiographic angular results than did patients treated with open surgery. However, the incidences of complications (OR 0.67, 95% CI 0.24 to 1.91, Z = 0.75, p = .45), recovery time (standard mean difference ‒3.09, 95% CI ‒7.98 to 1.80, Z = 1.24, p = .22), and patient-reported satisfaction (OR 2.76, 95% CI 0.72 to 10.65, Z = 1.48, p = .14) were similar between patients with hallux valgus treated with MIS and patients treated with open surgery. Heterogeneity between the sources of the pooled data threatened the validity of our observations, and we used statistical methods that aimed to limit such biases. At this time, more high-quality studies are needed to confirm or refute the results of this investigation.
本荟萃分析旨在比较微创手术(MIS)与传统开放手术矫正症状性拇外翻的临床疗效。进行了文献检索,共有11项研究纳入荟萃分析,其中1166例(52.98%)患者接受了MIS治疗,1035例(47.02%)患者接受了传统开放手术治疗。汇总数据(优势比[OR]6.28,95%置信区间[CI]3.20至12.32,Z = 5.35,p <.01)表明,接受MIS治疗的患者获得优良影像学角度结果的比例显著高于接受开放手术治疗的患者。然而,接受MIS治疗的拇外翻患者与接受开放手术治疗的患者在并发症发生率(OR 0.67,95%CI 0.24至1.91,Z = 0.75,p =.45)、恢复时间(标准化均数差‒3.09,95%CI‒7.98至1.80,Z = 1.24,p =.22)以及患者报告的满意度(OR 2.76,95%CI 0.72至10.65,Z = 1.48,p =.14)方面相似。汇总数据来源之间的异质性威胁到我们观察结果的有效性,我们使用了旨在限制此类偏差的统计方法。目前,需要更多高质量的研究来证实或反驳本调查结果。