The Timing of Surgery for Congenital Diaphragmatic Hernia in Infants, on or after Weaning from Extracorporeal Membrane Oxygenation: A Meta-Analysis.

IF 1.5 3区医学 Q2 PEDIATRICS

European Journal of Pediatric Surgery Pub Date : 2024-10-01 Epub Date: 2023-12-13 DOI:10.1055/a-2228-6969

Minhua Lin, Jiachi Liao, Le Li

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引用次数: 0

Abstract

Objectives: We conducted a meta-analysis of trials to determine the optimal time to conduct surgery for congenital diaphragmatic hernia (CDH) in infants, on or after weaning from extracorporeal membrane oxygenation (ECMO).

Methods: We searched the PubMed, Embase, Scopus, and Cochrane Library databases to identify relevant articles published prior to May 2023 in which surgery was performed to treat CDH in infants. Data were collected, and continuous data were represented by the mean difference (MD) and 95% confidence interval (CI). Dichotomous data were represented by the odds ratio (OR) and 95% CI. Review Manager V.5.4 and Stata were used to synthesize results and to assess publication bias.

Results: The results showed that infants undergoing surgery after being weaned from ECMO had reduced mortality (OR, 2.40; 95% CI, 1.23-4.69; p = 0.01) and postoperative bleeding rates (OR, 16.20; 95% CI, 5.73-45.76; p < 0.00001) and reduced ECMO duration (MD, 3.47; 95% CI, 1.89-5.05; p < 0.0001) compared with those who underwent surgery while on ECMO. There was no statistically significant difference in hospital duration (MD, 5.48; 95% CI, -8.66 to 19.62; p = 0.45) or ventilator duration (MD, -1.93; 95% CI, -8.55 to 4.68; p = 0.57).

Conclusion: We recommend weaning patients with CDH from ECMO before performing surgery.

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在体外膜氧合断奶时或断奶后对婴儿先天性膈疝进行手术的时机：荟萃分析。

目的：我们对试验进行了荟萃分析，以确定在体外膜氧合（ECMO）断奶时或断奶后进行婴儿先天性膈疝（CDH）手术的最佳时间：我们检索了 PubMed、Embase、Scopus 和 Cochrane 图书馆数据库，以确定 2023 年 5 月之前发表的相关文章，其中手术治疗了婴儿先天性膈疝。收集数据后，连续数据用平均差（MD）和95%置信区间（CI）表示。二分法数据用几率比（OR）和 95% Cl 表示。使用Review Manager V.5.4和Stata对结果进行综合并评估发表偏倚：结果显示，从 ECMO 断流后接受手术的婴儿死亡率降低（OR，2.40；95% Cl，1.23-4.69；P=0.01），术后出血率降低（OR，16.20；95% Cl，5.73-45.76；PConclusions：我们建议 CDH 患者在进行手术之前先从 ECMO 断流。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Journal of Pediatric Surgery 医学-外科

CiteScore

3.90

自引率

5.60%

发文量

审稿时长

6-12 weeks

期刊介绍： This broad-based international journal updates you on vital developments in pediatric surgery through original articles, abstracts of the literature, and meeting announcements. You will find state-of-the-art information on: abdominal and thoracic surgery neurosurgery urology gynecology oncology orthopaedics traumatology anesthesiology child pathology embryology morphology Written by surgeons, physicians, anesthesiologists, radiologists, and others involved in the surgical care of neonates, infants, and children, the EJPS is an indispensable resource for all specialists.