Efficacy of the fissureless technique on decreasing the incidence of prolonged air leak after pulmonary lobectomy: A meta-analysis.

Efficacy of the fissureless technique on decreasing the incidence of prolonged air leak after pulmonary lobectomy: A meta-analysis.

Int J Surg. 2017 Apr 13;:

Authors: Li SJ, Zhou K, Li YJ, Li PF, Wu YM, Liu LX, Che GW

Abstract
OBJECTIVE: The objective of our study was to evaluate the efficacy and safety of fissureless technique in pulmonary lobectomy by applying a meta-analysis of the current evidence.
METHODS: We searched the PubMed, EMBASE and the Web of Science databases to recognize the eligible articles. The relative risk (RR) and weighted mean difference (WMD) with the corresponding 95% confidence interval (CI) served as the summarized estimates for dichotomous variables and continuous variables, respectively. Sensitivity analysis and publication bias tests were also performed to perceive potential bias risks.
RESULTS: There were 6 studies with 843 surgical patients included into this meta-analysis. Finally, the meta-analysis demonstrated that fissureless technique could significantly reduce the incidence of prolonged air leak (PAL)[RR=0.40; 95%CI=(0.24, 0.68); P=0.001], the length of hospital stay [WMD=-0.52; 95%CI=(-0.87, -0.18); P=0.003] and the duration of chest tube [WMD=-0.44; 95%CI=(-0.74, -0.14); P=0.004]. Fissureless technique had also showed the benefit on decreasing the complication rate after lobectomy but without a statistical significance [RR=0.77; 95%CI=(0.55, 1.07); P=0.119]. In addition, no difference was observed in the operation time between the fissureless lobectomy and conventional lobectomy [WMD=5.32; 95%CI=(-3.18, 13.83); P=0.220].
CONCLUSIONS: Fissureless lobectomy is a superior alternative to conventional lobectomy in terms of preventing the PAL and shortening the length of hospital stay and chest tube duration. More multi-institution randomized controlled trials are required to confirm the validity of our findings in the future.

PMID: 28414119 [PubMed - as supplied by publisher]

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