在接受视频辅助胸腔镜手术的肺癌患者中转换为胸切除术的风险因素:元分析
Siyu Wang1, Hong Yan1, Jun Wen1
1School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province, People's Republic of China.
PloS one
|November 15, 2024
概括
年龄较大,男性性别,BMI较高,患有结核病,淋巴结扩大,肺部粘附,上叶瘤和较大的瘤大小增加了将肺癌视频辅助胸腔镜手术 (VATS) 转换为开放胸切除术的风险.
科学领域:
- 胸部外科手术 胸部外科手术
- 手术瘤学手术瘤学
- 肺部病理学 肺部病理学
背景情况:
- 视频辅助胸腔镜手术 (VATS) 是治疗肺癌的一种微创方法.
- 在VATS期间转换为胸切除术可能会使手术管理复杂化,并影响患者的结果.
- 识别转换的风险因素对于优化外科手术规划至关重要.
研究的目的:
- 在肺癌手术中从VATS转换为胸切除术时,系统评估与此相关的风险因素.
- 为开发个性化手术策略在肺癌治疗提供理论基础.
主要方法:
- 在多个数据库 (CNKI,Wanfang,VIP,CBM,PubMed,Cochrane Library,Web of Science,Embase) 进行了全面的文献搜索,截至2024年3月.
- 包括的研究重点是肺癌中VATS转化为胸切除术的风险因素.
- 使用Stata16.0软件对14项涉及10,605名患者的研究中提取的数据进行了元分析.
主要成果:
- 确定了11个VATS转换为胸切除术的危险因素.
- 显著的危险因素包括晚年 (≥65岁),男性性别,较高的BMI (≥25),结核病史,扩大的中或肺状淋巴结,多叶粘附,上叶瘤位置,袖叶切除术和瘤直径 (≥3.5cm).
结论:
- 在肺癌手术中,特定的患者和瘤特征是从VATS转换为胸切除术的重要预测因素.
- 术前对这些因素的评估可以帮助临床医生预测并可能减轻转换的需要,从而完善个性化手术计划.
- 由于目前的元分析的局限性,建议进行进一步的高质量研究来验证这些发现.
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