Department of Pediatric Surgery, Fujian Province Maternal and Child Health Hospital, Fuzhou, China.
J Laparoendosc Adv Surg Tech A. 2021 Jul;31(7):829-838. doi: 10.1089/lap.2020.0618. Epub 2021 Jun 1.
Evaluate the clinical efficacy and safety of minimally invasive surgery (MIS) and open surgery in the treatment of neuroblastoma (NB) in children by a meta-analysis. This is a meta-analysis. We searched for random or nonrandomized controlled study of MIS group and OPEN surgery group for the treatment of childhood NB included in PubMed, ClinicalTrials, EMBASE, and Cochrane library before January 31, 2020. Data extraction was performed in a standard format for the included studies, including tumor diameter, operation time, intraoperative bleeding, length of hospital stay (LOHS), complications, recurrence, and MYCN. Seven retrospective studies were finally included, with a total of 571 children, including 162 in MIS group and 409 in the OPEN surgery group. Compared with the OPEN surgery group, the MIS group had reduced intraoperative bleeding (mean difference [MD] = -12.72, 95% CI: -24.84 to -0.61, < .05), and reduced l LOHS (MD = -3.35, 95% CI: -5.55 to -1.15, < .05) and decreased postoperative recurrence (MD = 0.20, 95% CI: 0.05-0.75, < .05). The differences between the groups were statistically significant. There was no significant difference between groups in tumor diameter (MD = -18.84, 95% CI: -48.12 to 10.43, > .05), operation time (MD = -21.7, 95% CI: -97.52 to 54.13, > .05), and MYCN results (odds ratio = 2.27, 95% CI: 0.56-9.18, > .05). Preliminary evidence indicates that the treatment of NB with MIS has the advantages of less intraoperative bleeding, shorter LOHS, and less postoperative recurrence compared with open surgery.
采用荟萃分析评估微创手术 (MIS) 和开放性手术治疗儿童神经母细胞瘤 (NB) 的临床疗效和安全性。这是一项荟萃分析。我们检索了 2020 年 1 月 31 日前在 PubMed、ClinicalTrials、EMBASE 和 Cochrane 图书馆中纳入的 MIS 组和 OPEN 手术组治疗儿童 NB 的随机或非随机对照研究。按照纳入研究的标准格式进行数据提取，包括肿瘤直径、手术时间、术中出血量、住院时间 (LOHS)、并发症、复发和 MYCN。最终纳入 7 项回顾性研究，共 571 例患儿，其中 MIS 组 162 例，OPEN 手术组 409 例。与 OPEN 手术组相比，MIS 组术中出血量减少（均数差 [MD] =-12.72，95% CI：-24.84 至 -0.61， < .05），住院时间减少（MD =-3.35，95% CI：-5.55 至 -1.15， < .05），术后复发减少（MD =0.20，95% CI：0.05-0.75， < .05）。两组间差异有统计学意义。两组间肿瘤直径（MD =-18.84，95% CI：-48.12 至 10.43， > .05）、手术时间（MD =-21.7，95% CI：-97.52 至 54.13， > .05）和 MYCN 结果（比值比 = 2.27，95% CI：0.56-9.18， > .05）差异均无统计学意义。初步证据表明，与开放性手术相比，MIS 治疗 NB 具有术中出血少、住院时间短、术后复发少的优点。
