Perioperative outcomes of subxiphoid versus intercostal thoracoscopic surgery for anterior mediastinal tumors: A systematic review and meta-analysis
- VernacularTitle:经剑突下与经肋间入路胸腔镜手术治疗前纵隔肿瘤围术期结果的系统评价与Meta分析
- Author:
Weiqiang ZENG
1
;
Haili DANG
2
;
Yunjiu GOU
3
Author Information
1. The First Clinical Medical College of Gansu University of Chinese Medicine, Lanzhou, 730000, P. R. China
2. Department of Gastroenterology, Longnan Hospital of Traditional Chinese Medicine, Longnan, 746000, Gansu, P. R. China
3. Department of Thoracic Surgery, Gansu Provincial Hospital, Lanzhou, 730000, P. R. China
- Publication Type:Journal Article
- Keywords:
Video-assisted thoracoscopic surgery;
anterior mediastinal tumor;
minimally invasive surgery;
subxiphoid approach;
systematic review/meta-analysis
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2024;31(10):1514-1521
- CountryChina
- Language:Chinese
-
Abstract:
Objective To systematically evaluate the difference in clinical outcomes between subxiphoid video-assisted thoracoscopic surgery (SVATS) and intercostal video-assisted thoracoscopic surgery (IVATS) for anterior mediastinal tumor resection. Methods Online databases including The Cochrane Library, PubMed, EMbase, Web of Science, Sinomed, CNKI, Wanfang from inception to December 19, 2022 were searched by two researchers independently for literature comparing the clinical efficacy of SVATS and IVATS in treating anterior mediastinal tumors. Two researchers independently screened literature and extracted relevant data. The quality of the included literature was evaluated using the Newcastle-Ottawa Scale (NOS). The meta-analysis was performed by RevMan 5.3. Results A total of 12 studies with 1 517 patients were enrolled. NOS score≥6 points. The results of meta-analysis showed that compared with the IVATS, SVATS had less blood loss (MD=−17.76, 95%CI −34.21 to −1.31, P=0.030), less total postoperative drainage volume (MD=−70.46, 95%CI −118.88 to −22.03, P=0.004), shorter duration of postoperative drainage tube retention (MD=−0.84, 95%CI −1.57 to −0.10, P=0.030), lower rate of postoperative lung infections (OR=0.33, 95%CI 0.16 to 0.70, P=0.004), lower postoperative 24 h VAS pain score (MD=−1.95, 95%CI −2.64 to −1.25, P＜0.001) and 72 h VAS pain score (MD=−1.76, 95%CI −2.55 to −0.97, P＜0.001), and shorter postoperative hospital stay (MD=−1.12, 95%CI −1.80 to −0.45, P=0.001). There was no statistical difference in the operation time, the incidence of postoperative complications, incidence of postoperative phrenic nerve palsy or incidence of postoperative arrhythmia (P＞0.05). Conclusion SVATS for the treatment of anterior mediastinal tumors has high safety. Compared with the IVATS, the patients have less intraoperative blood loss and postoperative drainage volume, lower risk of postoperative pulmonary infection, less postoperative short-term pain, and shorter postoperative catheter duration and hospital stay, which is more conducive to rapid postoperative recovery.
