Effects Of Thoracoscopic Bullectomy And Mechanical Pleurodesis For Pneumothorax: A Meta-analysis

ObjectiveCurrent clinical for thoracoscopic bullectomy treatment spontaneous pneumothorax is required to simultaneously pleural friction technique remains controversial and uncertain.To systematically evaluate the effects of thoracoscopic bullectomy and thoracoscopic bullectomy combined with mechanical pleurodesis in the treatment spontaneous pneumothorax. MethodsWe searched Pub Med,Web of Science,The Cochrane Library,CBM,Wan Fang Data and CNKI from their inception to Dcember,2015,to collect randomized controlled trials(RCTs) of thoracoscopic bullectomy versus thoracoscopic bullectomy combined with mechanical pleurodesis in the treatment of spontaneous pneumothorax. Two reviewers independently screened literature according to the inclusion and exclusion criteria,extracted data and evaluated the risk of bias of included studies. Then,Rev Man5.2software was used for Meta-analysis. ResultsA total of 6 RCTs including 2302 patients were included. The results of Metaanalysis showed that: Compared with the simple thoracoscopic bullectomy,the thoracoscopic bullectomy combined with mechanical pleurodesis was superior in the postoperative drainage volume of primary spontaneous pneumothorax [MD=64.32,95%CI(5.72,122.92),P=0.03]. But there were no statistical differences in both groups in the recurrence rate of primary spontaneous pneumothorax [OR=1.03,95%CI(0.26,1.39),P=0.87],hospital stays of primary spontaneous pneumothorax [MD=0.02,95%CI(-0.48,0.89),P=0.96],the duration of drainage of primary spontaneous pneumothorax[SMD=0.00,95%CI(–0.10,0.10),P=1],operation time of primary spontaneous pneumothorax[MD=0.93,95%CI(-0.88,2.74),P=0.31],inoperative bleeding of primary spontaneous pneumothorax[MD=4.4,95%CI(–0.93,9.81),P=0.10],postoperative air leakage duration of primary spontaneous pneumothorax[SMD=0.05,95%CI(–0.15,0.25),P=0.63],postoperative chest tube duration of primary spontaneous pneumothorax[MD=-0.02,95%CI(-0.15,0.12),P=0.80] ConclusionExisting evidence the thoracoscopic bullectomy combined with mechanical pleurodesis can lead to increased postoperative drainage volume of primary spontaneous pneumothorax,in other ways,there were no statistical differences in both groups. For the surgical treatment of spontaneous pneumothorax, thoracoscopic bullectomy combined with mechanical pleurodesis is not superior to thoracoscopic bullectomy.