Department of Pediatric Surgery, Sichuan University West China Hospital, Chengdu, Sichuan, China.
Department of Pediatric Surgery, Sichuan University West China Hospital, Chengdu, Sichuan, China
BMJ Paediatr Open. 2023 Oct;7(1). doi: 10.1136/bmjpo-2023-001979.
The influence of lobectomy on pulmonary function in children was still controversial. A systematic review and meta-analysis were essential to explore whether pulmonary function was impaired after lobectomy in children.
PubMed, Embase and Web of Science were searched from 1 January 1946 to 1 July 2022. Forced expiratory volume in 1 s (FEV), forced vital capacity (FVC), FEV/FVC and total lung capacity were extracted from the studies as the primary analysis indicators. Subgroup analyses were performed between the congenital lung malformation (CLM) group and other diseases group, early surgery and late surgery group (1 year old as the dividing line).
A total of 5302 articles were identified through the search strategy; finally, 10 studies met the inclusion criteria. Through the meta-analysis, we found a mild obstructive ventilatory disorder in children who underwent lobectomy. However, a normal pulmonary function could be found in young children with CLM who underwent lobectomy, and the time of operation had no significant influence on their pulmonary function.
The overall result of pulmonary function after lobectomy in children was good. Surgeons may not need to be excessively concerned about the possibility of lung surgery affecting pulmonary function in children, particularly in patients with CLM.
CRD42022342243.
肺叶切除术对儿童肺功能的影响仍存在争议。系统评价和荟萃分析对于探讨儿童肺叶切除术后肺功能是否受损至关重要。
检索 1946 年 1 月 1 日至 2022 年 7 月 1 日的 PubMed、Embase 和 Web of Science 数据库。从研究中提取 1 秒用力呼气量（FEV）、用力肺活量（FVC）、FEV/FVC 和肺总量作为主要分析指标。在先天性肺畸形（CLM）组和其他疾病组、早期手术和晚期手术组（以 1 岁为分界线）之间进行亚组分析。
通过检索策略共确定了 5302 篇文章；最终有 10 项研究符合纳入标准。通过荟萃分析，我们发现肺叶切除术后儿童存在轻度阻塞性通气障碍。然而，行肺叶切除术的 CLM 幼儿的肺功能正常，手术时间对其肺功能无显著影响。
儿童肺叶切除术后总体肺功能结果良好。外科医生可能不必过度担心肺手术影响儿童肺功能的可能性，尤其是在 CLM 患者中。
PROSPERO 注册号：CRD42022342243。
