Division of Pediatric Surgery, Department of General surgery, Fengdu People's Hospital, Chongqing, China.
Department of Cardiothoracic Surgery, Children's Hospital of Chongqing Medical University, No. 136 Zhongshan Second Road, Yuzhong District, Chongqing, 400014, China.
Ther Adv Respir Dis. 2020 Jan-Dec;14:1753466620980267. doi: 10.1177/1753466620980267.
A meta-analysis was performed for a comparison of outcomes between video-assisted thoracoscopic surgery (VATS) and thoracotomy for congenital lung malformations (CLM).
Electronic databases, including PubMed, Scopus, Embase, and the Cochrane Library were searched systematically for literature aimed mainly at reporting the therapeutic effects for CLM administrated by VATS and thoracotomy.
A total of 40 studies meeting the inclusion criteria were included, involving 2896 subjects. VATS was associated with fewer complications [odds ratio (OR) 0.54; 95% confidence interval (CI), 0.42-0.69], less use of epidural anesthesia (OR, 0.08; 95% CI, 0.03-0.23), shorter length of hospital stay [standard mean difference (SMD) -0.98; 95% CI, -1.4 to -0.55] and chest drainage (SMD, -0.43; 95% CI, -0.7 to -0.17), as compared with thoracotomy. However, thoracotomy showed superiority in reduced operative time (SMD, 0.44; 95% CI, 0.04-0.84). Pearson analysis (Pearson = 0.85, 95% CI, 0.28 to 0.98, = 0.01) and linear regression ( square 0.73) confirmed a positive correlation between percentage of symptomatic cases and conversion in patients using VATS.
VATS is associated with fewer complications, less use of epidural anesthesia, shorter length of stay and length of chest drainage, but longer operative time, as compared with thoracotomy. Symptomatic patients with CLM using VATS may be prone to conversion to thoracotomy.
为了比较胸腔镜辅助手术（VATS）和开胸手术治疗先天性肺畸形（CLM）的结果，进行了一项荟萃分析。
系统地检索了电子数据库，包括 PubMed、Scopus、Embase 和 Cochrane 图书馆，以寻找主要报告 VATS 和开胸手术治疗 CLM 的治疗效果的文献。
共有 40 项符合纳入标准的研究被纳入，涉及 2896 名患者。与开胸手术相比，VATS 并发症较少[比值比（OR）0.54；95%置信区间（CI），0.42-0.69]，硬膜外麻醉使用率较低（OR，0.08；95%CI，0.03-0.23），住院时间[标准均数差（SMD）-0.98；95%CI，-1.4 至-0.55]和胸腔引流（SMD，-0.43；95%CI，-0.7 至-0.17）较短。然而，开胸手术在缩短手术时间方面具有优势（SMD，0.44；95%CI，0.04-0.84）。Pearson 分析（Pearson = 0.85，95%CI，0.28 至 0.98， = 0.01）和线性回归（平方 0.73）证实了使用 VATS 的患者中症状病例百分比与转换之间存在正相关。
与开胸手术相比，VATS 并发症较少，硬膜外麻醉使用率较低，住院时间和胸腔引流时间较短，但手术时间较长。使用 VATS 的 CLM 有症状患者可能更容易转为开胸手术。
