Journal of cardiothoracic surgery · 2026
Thoracoscopic versus non-thoracoscopic repair of pectus excavatum in children: a systematic review and meta-analysis.
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He Zhaopeng, Yu Zhanhang, Liao Zhenqi, Yao Xianming, Miao Xuefeng
Аннотация
OBJECTIVE: To compare perioperative outcomes between thoracoscopic (TPR) and non-thoracoscopic repair (NTPR) for pediatric pectus excavatum.
METHODS: A systematic literature search was conducted using PubMed and Embase to identify relevant comparative studies. Statistical analysis was performed using RevMan software, with continuous variables expressed as mean differences (MD) and dichotomous variables as odds ratios (OR), both with 95% confidence intervals (CI).
RESULTS: Five studies (1,905 patients: 430 NTPR, 1,475 TPR) were included (four retrospective cohort studies and one prospective study). Patients undergoing TPR were significantly older (MD -0.69 years, 95% CI -1.10 to -0.29, P = 0.0008). NTPR was associated with significantly shorter operative time (MD -15.37 min, 95% CI -27.43 to -3.32, P = 0.01), though with substantial heterogeneity (I²=90%). Hospital stay was comparable between groups. While not statistically significant, TPR consistently showed lower complication rates: cardiothoracic injuries (0.13% vs. 0.98%), pneumothorax (1.5% vs. 4.4%), and overall complications (3.2% vs. 7.4%).
CONCLUSIONS: TPR is associated with a favorable trend toward reduced postoperative complications compared to NTPR, although this did not reach statistical significance in the current analysis.
METHODS: A systematic literature search was conducted using PubMed and Embase to identify relevant comparative studies. Statistical analysis was performed using RevMan software, with continuous variables expressed as mean differences (MD) and dichotomous variables as odds ratios (OR), both with 95% confidence intervals (CI).
RESULTS: Five studies (1,905 patients: 430 NTPR, 1,475 TPR) were included (four retrospective cohort studies and one prospective study). Patients undergoing TPR were significantly older (MD -0.69 years, 95% CI -1.10 to -0.29, P = 0.0008). NTPR was associated with significantly shorter operative time (MD -15.37 min, 95% CI -27.43 to -3.32, P = 0.01), though with substantial heterogeneity (I²=90%). Hospital stay was comparable between groups. While not statistically significant, TPR consistently showed lower complication rates: cardiothoracic injuries (0.13% vs. 0.98%), pneumothorax (1.5% vs. 4.4%), and overall complications (3.2% vs. 7.4%).
CONCLUSIONS: TPR is associated with a favorable trend toward reduced postoperative complications compared to NTPR, although this did not reach statistical significance in the current analysis.