医学
围手术期
麻醉
心胸外科
优势比
子群分析
荟萃分析
电视胸腔镜手术
外科
内科学
作者
Yujie Wen,Hengrui Liang,Guanping Qiu,Zhi-Chao Liu,Jun Li,Weiqiang Ying,Wenhua Liang,Jianxing He
摘要
Abstract It remains unclear whether non-intubated video-assisted thoracoscopic surgery (VATS) is comparable or advantageous compared with conventional intubated VATS. Thus, we systematically assessed the feasibility and safety of non-intubated VATS compared with intubated VATS perioperatively for the treatment of different thoracic diseases. An extensive search of literature databases was conducted. Perioperative outcomes were compared between 2 types of operations. The time trend of the overall results was evaluated through a cumulative meta-analysis. Subgroup analyses of different thoracic diseases and study types were examined. Twenty-seven studies including 2537 patients were included in the analysis. A total of 1283 patients underwent non-intubated VATS; intubated VATS was performed on the other 1254 patients. Overall, the non-intubated VATS group had fewer postoperative overall complications [odds ratios (OR) 0.505; P < 0.001]; shorter postoperative fasting times [standardized mean difference (SMD) −2.653; P < 0.001]; shorter hospital stays (SMD −0.581; P < 0.001); shorter operative times (SMD −0.174; P = 0.041); shorter anaesthesia times (SMD −0.710; P < 0.001) and a lower mortality rate (OR 0.123; P = 0.020). Non-intubated VATS may be a safe and feasible alternative to intubated VATS and provide a more rapid postoperative rehabilitation time than conventional intubated VATS.
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