Dataset Information

A systematic review and meta-analysis of video-assisted thoracoscopic surgery treating spontaneous pneumothorax.

ABSTRACT:

Background

With the adoption of high-tech thoracoscopic surgical instruments, video-assisted thoracoscopic surgery (VATS) has gradually replaced traditional thoracotomy and is used in the clinical treatment of spontaneous pneumothorax.

Methods

The composite logic retrieval and Boolean logic retrieval methods were adopted for this meta-analysis. Databases such as PubMed, Medline, Cochrane Library, CNKI, Wanfang, VIP, and Google Scholar were searched using the combination of search terms "Video-assisted thoracoscopic surgery", "spontaneous pneumothorax", and "thoracotomy". Literatures which used video-assisted thoracoscopic surgery for spontaneous pneumothorax as the experimental group were screened. The software RevMan 5.3 provided by the Cochrane system was employed for meta-analysis.

Results

A total of 12 studies were included. After the meta-analysis, heterogeneity testing of the operation time in 8 studies showed that Tau² =29.99, Chi² =16.99, degrees of freedom (df) =7, I²=59%>50%, and the operation time of participants in the experimental group was considerably inferior to that of control group. The mean difference (MD) was -31.02, 95% confidence interval (95% CI: -36.07 to -25.97), Z=12.03, P<0.0001. The heterogeneity test of the length of hospital stay in 9 studies showed that Tau² =4.41, Chi² =122.58, df =8, I²=59%>50%, P<0.01, and the length of hospital stay of participants in the experimental group was remarkably shorter than that of the control group. The MD was -7.29, 95% CI: (-8.76 to -5.82), Z=9.74, and P<0.01. The heterogeneity test of the bleeding volume in 6 studies showed that Tau² =191.74, Chi² =27.65, df =5, I²=82%>50%, P<0.01, and the bleeding volume of participants in the experimental group was remarkably lower in contrast to that of the control group. The MD was -65.48, 95% CI: (-77.84 to -53.13), Z=10.39, and P<0.01. The heterogeneity test of the chest tube removal time in 7 studies showed that Tau² =0.29, Chi² =28.27, df =6, I²=79%>50%, P<0.05, and the chest tube removal time of participants in the experimental group was substantially lower in contrast to that of the control group. The MD was -3.10, 95% CI: (-3.56 to -2.64), Z=13.30, P<0.01.

Discussion

This meta-analysis confirmed that VATS for spontaneous pneumothorax is better than other surgical methods.

SUBMITTER: Lin Z

PROVIDER: S-EPMC8182496 | biostudies-literature | 2021 May

REPOSITORIES: biostudies-literature

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Publications

A systematic review and meta-analysis of video-assisted thoracoscopic surgery treating spontaneous pneumothorax.

Lin Zhenhai Z Zhang Zhidong Z Wang Qiugui Q Li Junhua J Peng Wen W Ge Guangquan G

Journal of thoracic disease 20210501 5

<h4>Background</h4>With the adoption of high-tech thoracoscopic surgical instruments, video-assisted thoracoscopic surgery (VATS) has gradually replaced traditional thoracotomy and is used in the clinical treatment of spontaneous pneumothorax.<h4>Methods</h4>The composite logic retrieval and Boolean logic retrieval methods were adopted for this meta-analysis. Databases such as PubMed, Medline, Cochrane Library, CNKI, Wanfang, VIP, and Google Scholar were searched using the combination of search ...[more]

PMID: 34164200

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Project description:IntroductionDetermining the prevalence of chronic postsurgical pain (CPSP) after video-assisted thoracoscopic surgery (VATS) and identifying CPSP predictors should improve the prognosis of patients undergoing VATS. Although several studies have investigated predictors of CPSP after VATS, there were significant dissimilarities in the findings due to the confounding of predictors.MethodsPubMed, Cochrane, MEDLINE, Web of Science, Chinese Biomedical Literature, and China National Knowledge Infrastructure databases were comprehensively searched using the Medical Subject Headings terms "pain, postoperative," "thoracic surgery, video-assisted," and all related free terms from inception until March 27, 2022. The Stata metaprop package was used to comprehensively analyze the incidence of CPSP following VATS. Furthermore, the pooled odds ratios (OR) or the standardized mean differences (SMD) and their corresponding 95% confidence intervals (95% CI) were calculated, and qualitative analyses were performed for predictors that could not be assessed quantitatively to evaluate the effects of the included risk factors on the occurrence of CPSP. Unadjusted odds ratios were utilized to consider the impact of non-significant estimates if the original study did not report them.ResultsOf the 4302 studies, 183 were considered eligible, and 17 were finally included in this study. The overall incidence of CPSP after VATS was 35.3% (95% CI 27.1-43.5%). The qualitative synthesis results revealed that female sex, age, and acute postoperative pain were definite predictors of CPSP after VATS. The number of ports, operation time, duration of drainage, and insufficient analgesia were also considered predictors. Consistent, quantitative synthesis results also showed that the aforementioned predictors were closely related to the occurrence of CPSP after VATS. Only by quantitative analysis, postoperative chemotherapy and an educational level less than junior school were also risk factors for CPSP. Other predictors displayed no evidence or unclear evidence of association with CPSP after VATS.ConclusionThis study preliminarily determined the incidence of CPSP after VATS based on the existing literature. Female sex, age, and acute pain were identified as risk factors for CPSP after VATS, and other potential risk factors were also identified and analyzed. However, as a result of the inclusion of retrospective studies and inevitable limitations in this systematic review and meta-analysis, the results of this study still need to be verified by large-scale prospective clinical studies.Trial registrationCRD42022323179.

Dataset Information

A systematic review and meta-analysis of video-assisted thoracoscopic surgery treating spontaneous pneumothorax.

Background

Methods

Results

Discussion

Publications

A systematic review and meta-analysis of video-assisted thoracoscopic surgery treating spontaneous pneumothorax.

Similar Datasets

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