| Objective:To systematically review the effect of transthoracic surgery and non-transthoracic surgery for cardiac cancer.Methods: PubMed?EMbase?CNKI ?WanFang Data and VIP were searched for the randomized controlled trials(RCT)of transthoracic surgery and non-transthoracic surgery for cardiac cancer.The methodological quality of the included studies were assessed.The STATA 12.0 software was used for meta-analysis.Results: According to the screening criteria,12 RCTs were enrolled in the study,and the total number of patients in this study was 2134.Among them,the number of the patients who accepted cardiac cancer treatment via transthoracic surgery and non-transthoracic surgery was 992 and 1142 respectively.The results of meta-analysis showed that the operative time,the hospital duration,the intraoperative blood loss,pulmonary complications,anastomotic fistula,wound infection,and reflux esophagitis in the non-transthoracic group were less than that in the transthoracic surgery group.However,there were no significant differences in the number of lymph nodes harvested,5-year survival rate,and cardiovascular complications after surgery.Conclusions: The present clinical trials show surgery is the first choice for the radical treatment of cardiac cancer with advantages and disadvantages via transthoracic and non-transthoracic approaches.For patients who have elderly,poor cardiopulmonary function,non-thoracic surgery is recommended preferentially.However,due to the limit of quality and samples in respective trials,more high-quality,large-scale randomized clinical trials are required for more accurate assessment to verify the optimal approach to cure cardiac cancer. |
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