{"title":"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。","authors":"Minhua Lin, Jiachi Liao, Le Li","doi":"10.1055/a-2228-6969","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong> 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).</p><p><strong>Methods: </strong> 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.</p><p><strong>Results: </strong> The results showed that infants undergoing surgery after being weaned from ECMO had reduced mortality (OR, 2.40; 95% CI, 1.23-4.69; <i>p</i> = 0.01) and postoperative bleeding rates (OR, 16.20; 95% CI, 5.73-45.76; <i>p</i> < 0.00001) and reduced ECMO duration (MD, 3.47; 95% CI, 1.89-5.05; <i>p</i> < 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; <i>p</i> = 0.45) or ventilator duration (MD, -1.93; 95% CI, -8.55 to 4.68; <i>p</i> = 0.57).</p><p><strong>Conclusion: </strong> We recommend weaning patients with CDH from ECMO before performing surgery.</p>","PeriodicalId":56316,"journal":{"name":"European Journal of Pediatric Surgery","volume":null,"pages":null},"PeriodicalIF":1.5000,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"The Timing of Surgery for Congenital Diaphragmatic Hernia in Infants, on or after Weaning from Extracorporeal Membrane Oxygenation: A Meta-Analysis.\",\"authors\":\"Minhua Lin, Jiachi Liao, Le Li\",\"doi\":\"10.1055/a-2228-6969\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objectives: </strong> 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).</p><p><strong>Methods: </strong> 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.</p><p><strong>Results: </strong> The results showed that infants undergoing surgery after being weaned from ECMO had reduced mortality (OR, 2.40; 95% CI, 1.23-4.69; <i>p</i> = 0.01) and postoperative bleeding rates (OR, 16.20; 95% CI, 5.73-45.76; <i>p</i> < 0.00001) and reduced ECMO duration (MD, 3.47; 95% CI, 1.89-5.05; <i>p</i> < 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; <i>p</i> = 0.45) or ventilator duration (MD, -1.93; 95% CI, -8.55 to 4.68; <i>p</i> = 0.57).</p><p><strong>Conclusion: </strong> We recommend weaning patients with CDH from ECMO before performing surgery.</p>\",\"PeriodicalId\":56316,\"journal\":{\"name\":\"European Journal of Pediatric Surgery\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.5000,\"publicationDate\":\"2024-10-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"European Journal of Pediatric Surgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1055/a-2228-6969\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2023/12/13 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q2\",\"JCRName\":\"PEDIATRICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"European Journal of Pediatric Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1055/a-2228-6969","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/12/13 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"PEDIATRICS","Score":null,"Total":0}
The Timing of Surgery for Congenital Diaphragmatic Hernia in Infants, on or after Weaning from Extracorporeal Membrane Oxygenation: A Meta-Analysis.
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.
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
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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.
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