Abstract：
The aim of this systematic review was to determine whether one-stage palatoplasty for children born with cleft lip and palate shows overall advantages in outcome compared with two-stage palatoplasty. The included studies were controlled studies of syndromic and non-syndromic children born with unilateral cleft lip and palate, bilateral cleft lip and palate, or isolated cleft palate. The interventions studied were one-stage palatoplasty and two-stage palatoplasty starting with the soft palate. The outcomes were facial growth, speech, hearing, presence of fistulae, other complications related to surgery, health-related quality of life, and health economics. In total, 14 original studies were included. Results were dichotomized into showing advantage for one- or two-stage palatoplasty for the respective outcome and compared with the results from six included systematic reviews. No overall advantage for either surgical strategy was found for any of the outcome measures. The certainty of evidence was highest for the presence of fistulae, followed by facial growth and speech. For several outcomes, the quality of the existing evidence was too low to allow for any conclusions to be drawn. Neither one- nor two-stage palatoplasty showed significant advantages in clinical outcomes compared with the other. Other aspects such as ethics, economics, or surgeon\'s preference might hence be of more importance. Homogenous choices of outcome measures and defined minimal clinically important differences would facilitate further research.
摘要：
这项系统评价的目的是确定与两阶段腭成形术相比，对唇腭裂患儿的一阶段腭成形术是否在预后方面显示出整体优势。纳入的研究是对出生有单侧唇腭裂的综合征和非综合征儿童的对照研究，双侧唇腭裂，或孤立的腭裂。所研究的干预措施是从软腭开始的一阶段pal成形术和两阶段pal成形术。结果是面部生长，演讲,听力,有瘘管,其他与手术有关的并发症，与健康相关的生活质量，和卫生经济学。总的来说,包括14项原始研究。将结果分为一阶段或两阶段pal成形术对各自结果的优势，并与六项纳入系统评价的结果进行比较。对于任何结果指标，均未发现两种手术策略的总体优势。对于瘘管的存在，证据的确定性最高，其次是面部发育和言语。对于几个结果，现有证据的质量太低，无法得出任何结论。与其他方法相比，一阶段或两阶段的腭成形术在临床结果上均未显示出显着优势。其他方面，如道德，经济学,或外科医生的偏好可能因此更重要。结果测量的同质选择和定义的最小临床重要差异将有助于进一步的研究。
