2. Department of Cardiology, Baotou Central Hospital, Baotou
014040, China.
Correspondence to:
Liang Wang;huang_manlin2021@163.comPhone number: +86138-9086-2882
523, Angel Building, Baotou Central Hospital, Inner Mongolia Autonomous
Region
【Key words 】Minimally invasive surgery; Mitral valve;
Thoracoscopy; Robot surgery; Traditional thoracotomy; Network
meta-analysis
►This is the first network meta-analysis focused on different surgical
treatments for mitral regurgitation to review all available literature.
► We employed rigorous methodology according to the Preferred Reporting
Items for Systematic Reviews and Meta-Analyses statement, and used the
Recommendations Assessment, using the software ADDIS 1.16.8 in the
review process.
►Due to special circumstances, the thoracoscopy assisted or robot
assisted surgery are not listed as separate surgical method to collect
data for subgroup analysis.
ABSTRACT
Objective This study has been compared the effectiveness of
different surgical methods in the treatment of
mitral regurgitation (MR) in
adults by using network meta-analysis method, so as to provide reference
for clinical selection of the best surgical scheme. Methods The
PubMed, EMBASE, the Cochrane Library, CNKI and Chongqing VIP Information
databases were comprehensively searched until December 2020. We
collected retrospective comparative studies on surgical procedures
including 3D endoscopic mitral valve surgery(3D-MVS),
robot assisted mitral valve
surgery(R-MVS); totally thoracoscopic mitral valve surgery(T-MVS), small
incision mitral valve surgery (M-MVS) and traditional thoracotomy mitral
valve surgery(C-MVS). Addis1.16.8 software was used for network
meta-analysis. Results A total of 31 studies were included,
12998 patients, involving 5 surgical methods. Network Meta analysis
showed that: in terms of complications (OR: 0.65, 95% CI: 0.13 to 3.00,
probability rank = 0.37) and mitral regurgitation (OR:0.03, 95%CI: 0.0
to 8315, probability rank=0.64), the 3D-MVS group had the lowest event
rate. In terms of blood transfusion rate (OR: 0.55, 95% CI: 0.16 to
1.84, probability rank=0.45), T-MVS had the lowest event rate. In
addition, with the exception of operation time and chest drainage, the
R-MVS group has the best curative effect. Conclusion These
minimally invasive surgery has their own advantages and disadvantages.
Overall, 3D-MVS is most satisfactory, but more samples are needed.
INPLASY registration number 202140138