School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province, People's Republic of China.
PLoS One. 2024 Nov 15;19(11):e0313236. doi: 10.1371/journal.pone.0313236. eCollection 2024.
To systematically evaluate the risk factors of conversion to thoracotomy in thoracoscopic surgery (VATS) for lung cancer, and to provide a theoretical basis for the development of personalized surgical plans.
CNKI, Wanfang, VIP, CBM, PubMed, Cochrane Library, Web of Science, and Embase databases were searched by computer from the establishment of the database to March 2024. Relevant studies on the risk factors of conversion to thoracotomy in VATS for lung cancer were searched. Two reviewers independently performed literature screening, data extraction, and quality evaluation, and Stata16.0 software was used for data analysis.
A total of 14 studies were included in this study, with a total sample size of 10605, and a total of 11 risk factors were obtained. Mate analysis showed that, Age ≥ 65 years old [OR(95%CI) = 2.61(1.67,4.09)], male [OR(95%CI) = 1.46(1.19,1.79)], BMI(Body Mass Index) ≥ 25 [OR(95%CI) = 1.79(1.17,2.74)], tuberculosis history [OR(95%CI) = 7.67(4.25,13.83)], enlarged mediastinal lymph nodes [OR(95%CI) = 2.33(1.50,3.06)], lung door swollen lymph nodes [OR(95%CI) = 6.33(2.07,19.32)], pleural adhesion [OR(95%CI) = 2.50(1.93,3.25)], tumor located in the lung Upper lobe [OR(95%CI) = 4.01(2.87,5.60)], sleeve lobectomy [OR(95%CI) = 3.40(1.43,8.08)], diameter of tumor ≥ 3.5cm [OR(95%CI) = 2.13(1.15,3.95)] associated with lung cancer VATS transit thoracotomy.
Age ≥ 65 years old, male, BMI ≥ 25, tuberculosis history, enlarged mediastinal lymph nodes, lung door swollen lymph nodes, pleural adhesion, tumor located in the lung Upper lobe, sleeve lobectomy, diameter of tumor ≥ 3.5cm are risk factors for conversion to thoracotomy during VATS for lung cancer. Clinicians should pay attention to the above factors before VATS to avoid forced conversion due to the above factors during VATS. Due to the number and limitations of the included studies, the above conclusions need to be validated by additional high-quality studies.
The protocol was registered into the PROSPERO database under the number CRD42023478648.
系统评价肺癌胸腔镜手术（VATS）中转开胸的危险因素，为制定个体化手术方案提供理论依据。
计算机检索中国知网、万方、维普、中国生物医学文献数据库、PubMed、Cochrane Library、Web of Science 和 Embase 数据库，从建库至 2024 年 3 月，搜集有关肺癌 VATS 中转开胸危险因素的研究。由 2 位研究者独立进行文献筛选、资料提取和质量评价，采用 Stata16.0 软件进行数据分析。
共纳入 14 项研究，累计样本量 10605 例，共提取出 11 个危险因素。Meta 分析结果显示，年龄≥65 岁[OR（95%CI）=2.61（1.67，4.09）]、男性[OR（95%CI）=1.46（1.19，1.79）]、体质量指数（BMI）≥25[OR（95%CI）=1.79（1.17，2.74）]、结核病史[OR（95%CI）=7.67（4.25，13.83）]、纵隔淋巴结肿大[OR（95%CI）=2.33（1.50，3.06）]、肺门区肿大淋巴结[OR（95%CI）=6.33（2.07，19.32）]、胸膜粘连[OR（95%CI）=2.50（1.93，3.25）]、肿瘤位于肺上叶[OR（95%CI）=4.01（2.87，5.60）]、袖式肺叶切除术[OR（95%CI）=3.40（1.43，8.08）]、肿瘤直径≥3.5cm[OR（95%CI）=2.13（1.15，3.95）]与肺癌 VATS 中转开胸相关。
年龄≥65 岁、男性、BMI≥25、结核病史、纵隔淋巴结肿大、肺门区肿大淋巴结、胸膜粘连、肿瘤位于肺上叶、袖式肺叶切除术、肿瘤直径≥3.5cm 是肺癌 VATS 中转开胸的危险因素。临床医师在 VATS 前应关注上述因素，避免因上述因素导致 VATS 中转开胸。受纳入研究数量及局限性的影响，上述结论尚需更多高质量研究予以验证。
该研究通过 PROSPERO 数据库进行注册，注册号为 CRD42023478648。
