The choice of dissection or preservation of the inferior pulmonary ligament after an upper lobectomy: a systematic review and meta-analysis
| Autor: | Xiaoying Zhang, Dongmei Di, Xianghong Zhan, Hao Lv, Yongxian Qian, Rui Zhou |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Lung Neoplasms Pulmonary ligament lcsh:Surgery 030204 cardiovascular system & hematology Cochrane Library lcsh:RC254-282 Inferior pulmonary ligament 03 medical and health sciences Postoperative Complications 0302 clinical medicine Upper lobectomy medicine Humans Pneumonectomy Randomized Controlled Trials as Topic Retrospective Studies Bronchus Ligaments business.industry Drainage time Research Dissection Significant difference Review manager lcsh:RD1-811 Prognosis lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens Preservation Surgery Meta-analysis medicine.anatomical_structure Oncology 030220 oncology & carcinogenesis business Organ Sparing Treatments |
| Zdroj: | World Journal of Surgical Oncology, Vol 18, Iss 1, Pp 1-10 (2020) World Journal of Surgical Oncology |
| ISSN: | 1477-7819 |
| Popis: | Background The necessity of the inferior pulmonary ligament (IPL) dissection after an upper lobectomy remains controversial. This meta-analysis aimed to evaluate whether this accessional procedure could reduce the postoperative complications and improve outcomes. Methods PubMed, Embase, Ovid, Cochrane Library, CBM, and CNKI databases were searched for the relevant studies which compared the dissection with preservation of IPL during the upper lobectomy. The Review Manager 5.3 software was used for this meta-analysis. Results Three RCTs and five CCTs were included in this meta-analysis. These studies contained a total of 610 patients, in which 315 patients received a pulmonary ligament dissection (group D) after the upper lobectomy, while the other 295 patients preserved the pulmonary ligament (group P). No significant difference was demonstrated between the group D and group P in terms of drainage time after surgery (MD 0.14, 95%CI − 0.05 to 0.33, P = 0.15), rate of postoperative dead space (OR 1.33, 95%CI 0.72 to 2.46, P = 0.36), rate of postoperative complications (OR 1.20, 95%CI 0.66 to 2.19, P = 0.56). However, the pooled comparison revealed a greater change of the right main bronchial angle (MD 5.00, 95%CI 1.68 to 8.33, P = 0.003) in group D compared with group P, indicated that the dissection of IPL may lead to a greater distortion of bronchus. Conclusions This meta-analysis confirmed that the dissection of IPL do not effectively reduce the postoperative complications and improve the prognosis. Therefore, it is not necessary to dissect the IPL after an upper lobectomy. |
| Databáze: | OpenAIRE |
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