Objective To systematically evaluate the safety based on discussing the postoperative complications of minimally invasive transthoracic device closure (MITDC) versus conventional surgical repair (SR) for the treatment of ventricular septal defects (VSD).Methods We searched the literature clinical controlled trials of investigating the postoperative complications of MITDC (experimental group) and SR (control group) for the treatment of VSD collected by the databases of PubMed,Ovid,CNKI,CSCD,Wanfang Data,CBM as of November 2016.RevMan 5.3 software was used for meta-analysis.Results A total of 3 879 patients in 16 studies were included in this study.The results of meta-analysis were as follows:the incidences of postoperative complications occurred in perioperative and follow-up periods were lower in the experimental group than in the control group (P<0.05).Aortic regurgitation occurred less frequently in the experimental group than in the control group during the postoperative follow-up period (P<0.05).The experimental group had lower incidence of right atrioventricular valve regurgitation during the perioperative and postoperative follow-up periods compared with the control group (P<0.05).A lower incidence of right bundle branch block was observed in the experimental group during the early postoperative period and postoperative follow-up period (P<0.05).Surgical mortality,incidence of residual shunt in the early postoperative period and postoperative follow-up period,incidence of aortic regurgitation during the perioperative period,incidence of arrhythmia and incidence of complete atrioventricular block did not differ significantly between the groups (P>0.05). Conclusion For VSD patients meeting the surgical indications,MITDC is recommended as a first choice treatment regimen, because it is safe and reliable,moreover,it has less complications compared with SR.However,due to the number and quality of included articles,its safety needs to be further confirmed by multi-center and long-term follow-up studies.%目的 系统评价经胸微创封堵手术(MITDC)与传统外科手术(SR)治疗室间隔缺损(VSD)术后并发症发生情况,探讨其安全性.方法 计算机检索PubMed、Ovid、中国知网、中国科学引文数据库(CSCD)、万方数据知识服务平台、中国生物医学文献数据库(CBM)等数据库,查找国内外发表的关于比较MITDC(试验组)与SR(对照组)治疗VSD术后并发症的对照试验,检索时限均为从建库至2016年11月,采用RevMan 5.3软件进行Meta分析.结果 纳入文献16篇,共计3879例患者.Meta分析结果显示:试验组围术期及术后随访期间手术并发症、术后随访期间主动脉瓣反流、围术期及术后随访期间右房室瓣反流、术后早期及术后随访期间右束支传导阻滞发生率低于对照组(P<0.05);两组手术死亡率、术后早期及术后随访期间残余分流、围术期主动脉瓣反流、总心律失常、完全性房室传导阻滞发生率比较,差异无统计学意义(P>0.05).结论 对于适应证范围内的VSD患者,MITDC治疗是安全可靠、并发症更少的有效方法,建议优先选择.受纳入研究的数量和质量所限,建议国内外多中心长期随访研究观察其安全性.
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