Safety and feasibility of no chest tube after thoracoscopic pneumonectomy: A systematic review and meta-analysis
- VernacularTitle:胸腔镜肺切除术后不留置胸腔引流管安全性和可行性的系统评价与 Meta 分析
- Author:
Fuan HU
1
;
Peng WANG
1
;
Wendeng LI
2
;
Linchong MA
1
;
Qingxin LI
3
,
4
Author Information
1. The Clinical Medical College of Ningxia Medical University, Yinchuan, 750004, P. R. China
2. The Clinical Medical College of Gansu University of Chinese Medicine, Lanzhou, 730000, P. R. China
3. Department of Cardiothoracic Surgery, The 940th Hospital of Joint Logistics Support Force of Chinese People&rsquo
4. s Liberation Army, Lanzhou, 730050, P. R. China
- Publication Type:Journal Article
- Keywords:
Pneumonectomy;
video-assisted thoracoscopic surgery (VATS);
chest drainage;
systematic review/meta analysis
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2022;29(11):1503-1510
- CountryChina
- Language:Chinese
-
Abstract:
Objective To discuss the safety and feasibility of no chest tube (NCT) after thoracoscopic pneumonectomy. Methods The online databases including PubMed, EMbase, The Cochrane Library, Web of Science, China National Knowledge Infrastructure (CNKI), WanFang Database, VIP, China Biology Medicine disc (CBMdisc) were searched by computer from inception to October 2020 to collect the research on NCT after thoracoscopic pneumonectomy. Two reviewers independently screened the literature, extracted the data, and evaluated the quality of the included studies. The RevMan 5.3 software was used for meta-analysis. Results A total of 17 studies were included. There were 12 cohort studies and 5 randomized controlled trials including 1 572 patients with 779 patients in the NCT group and 793 patients in the chest tube placement (CTP) group. Meta–analysis results showed that the length of postoperative hospital stay in the NCT group was shorter than that in the CTP group (SMD=–1.23, 95%CI –1.59 to –0.87, P<0.000 01). Patients in the NCT group experienced slighter pain than those in the CTP group at postoperative day (POD)1 (SMD=–0.97, 95%CI –1.42 to –0.53, P<0.000 1), and POD2 (SMD=–1.10, 95%CI –2.00 to –0.20, P=0.02), while no statistical difference was found between the two groups in the visual analogue scale of POD3 (SMD=–0.92, 95%CI –1.91 to 0.07, P=0.07). There was no statistical difference in the 30-day complication rate (RR=0.93, 95%CI 0.61 to 1.44, P=0.76), the rate of postoperative chest drainage (RR=1.51, 95%CI 0.68 to 3.37, P=0.31) or the rate of thoracocentesis (RR=2.81, 95%CI 0.91 to 8.64, P=0.07) between the two groups. No death occurred in the perioperative period in both groups. Conclusion It is feasible and safe to omit the chest tube after thoracoscopic pneumonectomy for patients who meet the criteria.
