Effect of Sequence of Pulmonary Artery and Vein Transection in Thoracoscopic Lobectomy on Efficacy and Safety of Patients with Non-small Cell Lung Cancer: A Systematic Evaluation
10.3971/j.issn.1000-8578.2023.22.0593
- VernacularTitle:胸腔镜肺叶切除术中肺动、静脉切断顺序对非小细胞肺癌患者手术疗效与安全性影响的系统评价
- Author:
Xiangdou BAI
1
;
Ziqiang HONG
;
Baiqiang CUI
;
Ning YANG
;
Xiaoyang HE
;
Dacheng JIN
;
Yunjiu GOU
Author Information
1. The First Clinical Medical College of Gansu University of Chinese Medicine, Lanzhou 730000, China
- Publication Type:Research Article
- Keywords:
Non-small cell lung cancer;
Lobectomy;
Pulmonary artery;
Pulmonary vein;
Detachment sequence;
Comparison of curative effects;
Systematic review
- From:
Cancer Research on Prevention and Treatment
2023;50(1):69-74
- CountryChina
- Language:Chinese
-
Abstract:
Objective To systematically evaluate the effect of sequence of pulmonary artery and vein transection in thoracoscopic lobectomy on the efficacy and safety of patients with non-small cell lung cancer. Methods PubMed, EMbase, Web of Science, The Cochrane Library, CNKI, Wanfang, VIP and CBM databases were searched for the researches on The post-operative efficacy of pulmonary arteriovenous and pulmonary vein resection sequence in thoracoscopic lobectomy for non-small cell lung cancer. The retrieval time is from the database construction to May 2022. Meta-analysis was performed using RevMan 5.4 software. Results Eight articles were included, including 3 randomized controlled studies and 5 cohort studies, with a total of 1810 patients. Meta-analysis results showed that: The operative time (MD=13.34, 95%CI(7.36, 19.32), P < 0.0001) and intraoperative blood loss (MD=45.29, 95%CI(40.24, 50.35), P < 0.0001) in the group with priority pulmonary vein resection were significantly higher than those in the group with priority pulmonary vein resection. The difference was statistically significant. However, the benefits of OS (HR=1.34, 95%CI (1.12, 1.60), P=0.001) and DFS (HR=1.44, 95%CI(1.18, 1.76), P=0.0003) in the group of priority pulmonary vein transection were significantly better than those in the group of priority pulmonary artery transection, with statistically significant differences. Conclusion Priority pulmonary vein transection during thoracoscopic lobectomy effectively improved patients' OS and DFS, resulting in higher survival benefit for patients with non-small cell lung cancer, but intraoperative bleeding and operation time are more than those with priority pulmonary artery transection.
