Effect of chest tube size on pleurodesis efficacy in malignant pleural effusion: a meta-analysis of randomized controlled trials
Autor: | Upendra Kaphle, Dingding Zhang, Shokufeh M. Ramirez, Fayez Kheir, Inderpal S. Thethi, Wei Shen, Maha Mohamad |
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Rok vydání: | 2018 |
Předmět: |
Pulmonary and Respiratory Medicine
medicine.medical_specialty business.industry medicine.medical_treatment medicine.disease Confidence interval law.invention Chest tube 03 medical and health sciences 0302 clinical medicine 030228 respiratory system Randomized controlled trial law Meta-analysis Relative risk medicine Malignant pleural effusion Original Article 030212 general & internal medicine Radiology Complication business Pleurodesis |
Zdroj: | Journal of Thoracic Disease. 10:355-362 |
ISSN: | 2077-6624 2072-1439 |
Popis: | Background: Malignant pleural effusion (MPE) develops in approximately 50% of all patients with metastatic cancer. The efficacy of small- vs. large-bore chest tube for pleurodesis in patients with MPE is still not clear. Methods: We performed a meta-analysis to evaluate the efficacy and safety of chest tube size in the management of MPE. A systematic search of Medline (Ovid) and Embase (from 1980 to March 2016) was performed. Randomized clinical trials (RCTs) evaluating the effect of small (≤14 French) vs. large (>14 French) chest tube size on successful pleurodesis for patients with MPE. Of 708 potentially relevant publications, four matched the selection criteria and were included in the meta-analysis. Results: Overall relative risk (RR) with 95% confidence intervals (CI) was pooled using a random-effects model. Heterogeneity was assessed using Q statistic (significant at P 2 =17.4%) and 0.95 (95% CI, 0.42–2.15; P=0.90; I 2 =0.9%) respectively. Successful pleurodesis and complication proportion for small vs. large chest tubes were 73.8% vs. 82.0% and 13.0% vs. 10.5%, respectively. Conclusions: This meta-analysis suggests that small and large chest tubes are both effective treatment for MPE with similar successful pleurodesis and complication proportion. Further RCTs are needed to more clearly determine which size tube is superior. |
Databáze: | OpenAIRE |
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