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胸腔镜与开胸肺叶切除术治疗儿童先天性肺病变的比较:系统评价和荟萃分析。

Thoracoscopic versus thoracotomy lobectomy in children with congenital lung lesions: a systematic review and meta-analysis.

机构信息

Department of Cardiothoracic Surgery, Children's Hospital of Soochow University, Suzhou, China.

Department of General Surgery, Xuzhou Children's Hospital, Xuzhou Medical University, Xuzhou, China.

出版信息

ANZ J Surg. 2024 Feb;94(1-2):208-214. doi: 10.1111/ans.18859. Epub 2024 Jan 23.

Abstract

BACKGROUND

Thoracoscopic lobectomy is always compared with open thoracotomy in congenital lung lesions with no definitive results. This systematic review and meta-analysis compared the clinical outcomes of thoracoscopic versus thoracotomy lobectomy in children.

METHODS

The electronic databases MEDLINE, EMBASE, and PubMed were searched. A meta-analysis was used to analyse and compare the operating time, length of hospital stay, and postoperative complications, such as wound infections and respiratory issues, in thoracoscopic and thoracotomy lobectomy.

RESULTS

Two thousand and ninety five paediatric patients were analysed over 17 studies (1 ambidirectional cohort study and 16 retrospective studies). Of these patients, 903 and 1192 had undergone thoracoscopic lobectomy and thoracotomy, respectively. There was a significant lower incidence of overall and respiratory complications and longer operative time for thoracoscopic lobectomy compared with thoracotomy in children; however, pooling the results for the two methods revealed no significant difference in wound infection or length of hospital stay.

CONCLUSION

Thoracoscopic lobectomy offers the benefit of having fewer overall and respiratory complications than thoracotomy. It did not, however, clearly outperform open surgery in terms of operative time, wound infection, or postoperative hospitalization.

摘要

背景

胸腔镜肺叶切除术与开放性剖胸术在先天性肺病变中一直进行比较,但没有明确的结果。本系统评价和荟萃分析比较了胸腔镜与开放性剖胸术治疗儿童肺叶切除的临床结果。

方法

检索电子数据库 MEDLINE、EMBASE 和 PubMed。使用荟萃分析分析和比较胸腔镜与开放性剖胸术的手术时间、住院时间以及术后并发症,如伤口感染和呼吸问题。

结果

在 17 项研究中分析了 2095 名儿科患者(1 项双向队列研究和 16 项回顾性研究)。这些患者中,903 例行胸腔镜肺叶切除术,1192 例行开放性剖胸术。与开放性剖胸术相比,胸腔镜肺叶切除术的总体和呼吸并发症发生率较低,手术时间较长;然而,两种方法的结果汇总显示,伤口感染或住院时间无显著差异。

结论

胸腔镜肺叶切除术的总体和呼吸并发症发生率低于开放性剖胸术。然而,在手术时间、伤口感染或术后住院时间方面,它并没有明显优于开放性手术。

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