上肺叶切除术中分离肺下韧带是否能改善短期临床结果和长期生存?

IF 1.6 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS
Yi-Feng Wang, Han-Yu Deng, Weijia Huang, Qinghua Zhou
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引用次数: 0

摘要

胸外科最佳证据主题是根据结构化协议编写的。问题是“上肺叶切除术中分离肺下韧带(IPL)是否能改善短期临床结果和长期生存?”使用报告检索共发现43篇论文,其中6项研究代表了回答临床问题的最佳证据,包括先前最佳证据主题研究,荟萃分析和4项回顾性队列研究。这些论文的作者、期刊、发表日期和国家、研究的患者群体、研究类型以及相关的结果和结果以表格形式列出。大多数纳入的研究报道,分割组与保留组在引流时间、引流量、术后死腔及并发症方面无显著差异。而3项队列研究显示,分组组术后肺功能不佳,包括肺容量、用力肺活量和1s用力呼气量。先前的荟萃分析和最近的一项队列研究也发现,IPL的分裂可能导致支气管角度变化或扭转增加。此外,2项队列研究发现,IPL的分割并不能提高上肺叶切除术患者的长期生存率。目前的证据表明,分割IPL不能带来临床益处,反而可能导致肺功能下降。因此,我们建议在上肺叶切除术时,不要常规解剖IPL。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Does the division of the inferior pulmonary ligament in upper lobectomy result in improved short-term clinical outcomes and long-term survival?

A best evidence topic in thoracic surgery was written according to a structured protocol. The question addressed was 'Does the division of the inferior pulmonary ligament (IPL) in upper lobectomy result in improved short-term clinical outcomes and long-term survival?'. Altogether 43 papers were found using the reported search, of which 6 studies represented the best evidence to answer the clinical question, including a previous best evidence topic study, a meta-analysis and 4 retrospective cohort studies. The author, journal, date and country of publication, patient group studied, study type and relevant outcomes and results of these papers are tabulated. Most of the enrolled studies reported that there is no significant difference between the division groups and the preservation groups in terms of drainage time, drainage volume, postoperative dead space and complications. While 3 cohort studies revealed unfavoured postoperative pulmonary function in the division groups, including lung volume, forced vital capacity and forced expiratory volume in 1 s. The previous meta-analysis and a recent cohort study also found that the division of IPL might lead to increased bronchus angle change or torsion. Moreover, 2 cohort studies found that the division of IPL could not improve the long-term survival of patients undergoing upper lobectomy. Current evidence showed that dividing the IPL could not result in clinical benefits but might lead to decreased pulmonary function instead. Therefore, we recommended not dissecting the IPL routinely during upper lobectomy.

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来源期刊
Interactive cardiovascular and thoracic surgery
Interactive cardiovascular and thoracic surgery CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
3.30
自引率
0.00%
发文量
292
审稿时长
2-4 weeks
期刊介绍: Interactive CardioVascular and Thoracic Surgery (ICVTS) publishes scientific contributions in the field of cardiovascular and thoracic surgery, covering all aspects of surgery of the heart, vessels and the chest. The journal publishes a range of article types including: Best Evidence Topics; Brief Communications; Case Reports; Original Articles; State-of-the-Art; Work in Progress Report.
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