Meta Analysis Of Clinical Effect And Safety Of Simultaneous And Staged Bilateral Lung Tumor Resection

Objective:Meta analysis was used to evaluate the clinical effect and safety of simultaneous bilateral lung surgery and staged bilateral lung surgery in the resection of lung tumors,so as to provide a reference basis for the selection of simultaneous bilateral lung surgery for clinical treatment.Methods:The two researchers involved in the study searched Pub Med,Cochrane library,Web of science,EMBASE Wan fang database and CNKI with computer system,and manually searched all possible literature on the comparison of clinical effects of bilateral simultaneous lung surgery and bilateral staged lung surgery.The retrieval time was from the establishment of the database to January 2022.The selected languages were Chinese and English,and the obtained literature was traced back,It ensures the integrity of the literature.The two participants in the study formulated the inclusion and exclusion criteria of the literature,strictly followed the inclusion and exclusion criteria,and collected randomized controlled trials and cohort studies of relevant contents.For the different types of literature included,the literature quality evaluation tool is used to evaluate the quality of the literature,the general clinical materials and data are extracted from the selected literature,the statistical analysis software(Stata software)is used to statistically analyze the selected research data,and the Q-test and I2 value are used to test the heterogeneity between each study.If the heterogeneity is large(I2≥50%,P < 0.05),the random effect model is used for data consolidation and statistics,If the heterogeneity is small(I2 ≤50%,P > 0.05),the fixed effect model is used.Calculate the standard mean difference,odds ratio and respective 95% confidence interval of each research index,and analyze the statistical bias of each research by t-test.P≤0.05 is that the research data are biased,and the funnel chart method is used to evaluate the publication bias.Result: Pub Med,EMBASE,Cochrane Library and Web of science databases were searched by using the search term "Lung surgery,Bilateral synchronous lung,Multiple primary lung cancer,Bilateral pulmonary nodules,lung cancer,Multiple primary pulmonary nodules,Staged lung surgery,Thoracoscopic surgery,Simultaneous lung surgery,Staged lung surgery,Intrapulmonary lesions,Thoracotomy",and CNKI Electronic Library and Wanfang database were searched by using the search term "Thoracoscopic surgery,double lung multiple nodules,multiple primary lung cancer,lung cancer,simultaneous lung surgery,staged lung surgery,lung surgery,thoracotomy,intrapulmonary lesions".A total of1184 relevant documents were obtained.After the retrieved literature was imported into the literature management software,the duplicate data was deleted.After preliminary screening according to the initially readable information(such as the title of the literature),the literature was downloaded,the full text was read,and these literatures were re screened according to the inclusion and exclusion criteria.Finally,7 retrospective cohort studies were included,a total of 531 patients,and 7 literatures were published in recent 10 years.Results of Meta-Analysis: compared with staged bilateral lung surgery,simultaneous bilateral lung surgery can reduce the operation time [SMD =-1.665,95% CI(-2.476,-0.855),P < 0.05].The amount of intraoperative bleeding [SMD =-1.665,95% CI(-3.638,0.309),P = 0.098 > 0.05],days of indwelling chest tube [SMD =-1.167,95% CI(-3.619,1.285),P = 0.351 >0.05],days of postoperative hospitalization [SMD =-0.796,95% CI(-1.826,0.233),P = 0.130 > 0.05],postoperative complications [or = 1.046,95% CI(0.280,3.901),P= 0.947 > 0.05],There was no significant difference in postoperative pulmonary infection [or = 1.042,95% CI(0.632,1.718),P = 0.871 > 0.05],postoperative wound infection [or = 0.387,95% CI(0.077,1.951),P = 0.250 > 0.05].Conclusion: 1.In terms of operation time,the operation time of bilateral lung surgery in the same period is shorter.2.There was no significant difference in intraoperative bleeding,postoperative hospital stay,days of indwelling chest catheter and complications between the two operations.