Evidence map›Paper›PMID 34533876›Full record

SynthesisThe international journal of medical robotics + computer assisted surgery : MRCAS2021

Complications of robot-assisted thymectomy: A single-arm meta-analysis and systematic review.

Jia-Xin Xu, Kai Qian, Yi Deng, Yan-Yan Zheng, Chun-Mei Ou, Jie Liu, Li-Hong Jiang

Abstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in The international journal of medical robotics + computer assisted surgery : MRCAS, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Complications of robot-assisted thymectomy: A single-arm meta-analysis and systematic review.The international journal of medical robotics + computer assisted surgery : MRCAS · 2021
    Pooled it
  3. Review
  4. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Jia-Xin XuDepartment of Cardio-Thoracic surgery, Institute of Yan'an Hospital Affiliated to Kunming Medical University, Kunming, China.ORCID https://orcid.org/0000-0003-0478-5215
Kai QianFaculty of Life and Biotechnology, Institute of Kunming University of Science and Technology, Kunming, China.
Yi DengFaculty of Life and Biotechnology, Institute of Kunming University of Science and Technology, Kunming, China.
Yan-Yan ZhengRegenerative Medicine Research Center, Institute of the First People's Hospital of Yunnan Province, Kunming, China.
Chun-Mei OuDepartment of Thoracic Surgery, Institute of the First People's Hospital of Yunnan Province, Kunming, China.
Jie LiuRegenerative Medicine Research Center, Institute of the First People's Hospital of Yunnan Province, Kunming, China.
Li-Hong JiangDepartment of Thoracic Surgery, Institute of the First People's Hospital of Yunnan Province, Kunming, China.

Funding

Lihong Jiang 81960068
6 · The paper itself

Abstract

backgroundRecently, thymectomy using minimally invasive approaches has been increasing with the development of robotic video-assisted thoracoscopic surgery (R-VATS). Although multimodal approach is effective for robot assisted thymectomy, it is necessary to determine the approach (left, right or subxiphoid) associated with the least complications.

methodsAn electronic retrieval from PubMed, Embase, Web of Science, GreyNet International and The Cochrane Library. The single-arm meta-analysis was performed to compare the rate of complications of right- and left-side approaches by R-VATS.

resultsA total of 21 studies including 930 patients were identified. The pooled incidence of total complications was 12.2% (confidence interval: 10.0%-14.8%) for all studies. The overall complication rate was 17.3% for the right-side compared with 7.4% for the left side (P < 0.001, odds ratio = 2.484, 1.601-3.852). The pooled incidence of air leak was significantly higher for the right versus left side (5.1% vs. 1.2%, respectively; p = 0.004). The incidence of atrial fibrillation was higher for the right-side compared with the left-side approach (4% vs. 1.2%, respectively; p = 0.004). The open conversion rate was significantly higher for the right versus the left-side (6.5% vs. 2.9%, respectively; p = 0.004). However, there was no significant difference in the pooled incidence of pleural effusion and thoracic duct fistula when comparing the right- and left-side approaches. In subgroup analysis, in the left approach, the incidence of overall complications (28.6% vs. 5.5%, respectively; p = 0.002) and pleural effusion (14.3% vs. 1%, respectively; p = 0.002) was higher for the 'Old Age' group compared with the 'Youth' group; However, In the subgroup analysis of gender, there was no significant difference in the incidence of complications after thymectomy.

conclusionRobotic video-assisted thoracoscopic surgery can be performed on the left- and right-sides; however, complications are minimal with the left-side approach. These data demonstrate that the incidence of overall complications, atrial fibrillation, open conversion ratios, and air leak rate of left-side R-VATS thymectomy are lower than those of right-side. Further subgroup analysis showed that the incidence of postoperative complications was higher in the older group.

Indexed as

RoboticsThymectomyAdolescentHumansPostoperative ComplicationsThoracic Surgery, Video-AssistedTreatment Outcomecomplicationmeta-analysisthoracoscopicthymectomy

Identifiers

PMID34533876
PMCPMC9285085

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.