Lingyun Wei, Ke Sha, Jinmin Zhao, Yu Qiao, Jun Qin
Research Centre for Regenerative Medicine, Orthopaedic Department, The First Affiliated Hospital of Guangxi Medical University, Nanning, China.
Guangxi Key Laboratory of Regenerative Medicine, Guangxi Medical University, Nanning, China.
Front Neurol. 2022 Jul 6;13:899120. doi: 10.3389/fneur.2022.899120. eCollection 2022.
Many publications report outcomes of surgical treatment for neurothoracic outlet syndrome (NTOS); however, high-quality meta-analyses regarding objective evaluation system accessing the long-term outcome of NTOS are lacking. This meta-analysis summarizes and compares the outcomes of Derkosh's classification and vas visual analog scale of the supraclavicular neuroplastic of brachial plexus (SNBP) and trams auxiliary first rib resection (TFRR).
The Cochrane Library, PubMed, EMBASE, Allied and Complementary Medicine (AMED) were searched for papers published between January 1980 and February 2021, using the keywords "thoracic outlet syndrome," "treatment, surgical." Articles were eligible for inclusion if the following criteria were met studies describing outcomes of surgery for NTOS, published in English, human studies, and available in full text. The exclusion criteria were case reports ( < 10), reviews, abstracts, and studies lacking a control group or without evaluation for two types of surgery.
We included 10 studies with 1,255 cases, out of which 622 were in the SNBP group; and 633 were in the TFRR group. After surgery (≥12 months), Derkash's classification was improved in 425 cases with SNBP and 364 cases with TFRR. OR = 1.34 (95% CI: 0.94, 1.92), = 0.03; vas visual analog scale was improved in 282 cases in the SNBP group and 214 cases in the TFRR group. OR = 1.08 (95% CI: 0.63, 1.85), = 0.78.
This meta-analysis shows that both SNBP and TFRR are effective for NTOS, but that SNBP is better than TFRR in improving Derkash's classification in the long term. Although patients treated with SNBP are more satisfactory, there is no significant difference in vas visual analog scale from TFRR.
https://www.crd.york.ac.uk/PROSPERO/display_record.asp?ID=CRD42021254203, PROSPERO CRD42021254203.
许多出版物报道了神经胸廓出口综合征（NTOS）的外科治疗结果；然而，缺乏关于评估NTOS长期结果的客观评价系统的高质量荟萃分析。本荟萃分析总结并比较了德尔科什分类法以及臂丛神经锁骨上神经成形术（SNBP）和经腋路第一肋切除术（TFRR）的视觉模拟量表的结果。
检索考克兰图书馆、PubMed、EMBASE、综合与补充医学数据库（AMED）中1980年1月至2021年2月发表的论文，使用关键词“胸廓出口综合征”“治疗，外科手术”。如果符合以下标准，则文章 eligible for inclusion：描述NTOS手术结果的研究、以英文发表、人体研究且有全文。排除标准为病例报告（<10例）、综述、摘要以及缺乏对照组或未对两种手术进行评估的研究。
我们纳入了10项研究，共1255例病例，其中SNBP组622例；TFRR组633例。术后（≥12个月），SNBP组425例和TFRR组364例的德尔卡什分类得到改善。OR = 1.34（95% CI：0.94，1.92），P = 0.03；SNBP组282例和TFRR组214例的视觉模拟量表得到改善。OR = 1.08（95% CI：0.63，1.85），P = 0.78。
本荟萃分析表明，SNBP和TFRR对NTOS均有效，但从长期来看，SNBP在改善德尔卡什分类方面优于TFRR。虽然接受SNBP治疗的患者更满意，但在视觉模拟量表方面与TFRR无显著差异。
https://www.crd.york.ac.uk/PROSPERO/display_record.asp?ID=CRD42021254203，PROSPERO CRD42021254203。
