剑突下与侧胸入路手术治疗前纵隔肿瘤疗效的Meta分析

Efficacy of Subxiphoid and Lateral Thoracic Approaches in the Treatment of Anterior Mediastinal Tumors: A Meta-Analysis

目的:本研究采用荟萃分析评价胸腔镜下剑突入路与侧胸入路治疗前纵隔肿瘤的疗效。方法:计算机检索PubMed、Embase、Cochrane、Web of science、CNKI、VIP、WanFang数据库,搜集胸腔镜经剑突与侧胸手术治疗前纵隔肿瘤的对照试验,检索时间均为建库至2022年5月,由两名研究者独立进行文献筛选、资料提取及偏倚风险评价。采用StataSE 15进行Meta分析并绘制相关图表。结果:纳入符合条件的16篇RCT,共1333名患者。Meta分析结果显示:剑突下入路相比侧胸入路,其手术时间、住院时间、术后置管时间较短,术中出血、术后引流量较少,术后疼痛较轻,术后并发症发生率较低。结论:对于前纵隔肿瘤,剑突下入路方式在各观察指标中更有优势,是一种安全有效的术式。

Aim: This meta-analysis was conducted to evaluate the efficacy of subxiphoid approach and lateral thoracic approach used in thoracoscopic surgery for treating anterior mediastinal tumors. Methods: PubMed, Embase, Cochrane, Web of science, CNKI, VIP, WanFang databases were searched to retrieve controlled trials of treating anterior mediastinal tumors by thoracoscopic surgery via subxiphoid approach and lateral thoracic approach. The retrieval time was from the establishment of the database to May 2022. Two investigators independently completed literature screening, data extraction, and risk of bias assessment. StataSE 15 was used for meta-analysis and plotting the charts. Results: A total of 16 eligible RCTs involving 1333 patients were included. The results of the meta-analysis showed that compared with the lateral thoracic approach, the subxiphoid approach demonstrated shorter operation time, hospital stay, and postoperative catheterization time, less intraoperative hemorrhage, postoperative drainage volume and postoperative pain, as well as lower incidence of postoperative complications. Conclusion: For anterior mediastinal tumors, the subxiphoid approach has more advantages in various observation indicators, and is a safe and effective surgical approach.