■不孕症是儿童癌症治疗的重要晚期效应。卵巢组织冷冻保存(OTC)是一种安全的方法,可以在(青春期前)患有癌症的女孩中保存性腺组织。然而,目前尚不清楚在<1岁的癌症婴儿中是否也可以安全地进行选择性腹腔镜OTC。本系统评价旨在评估接受选择性腹腔镜检查的婴儿死亡率的报告风险。和/或危重事件(包括复苏,循环,呼吸,神经毒性,其他)手术期间和手术后不久。
■本系统评价遵循系统评价和荟萃分析(PRISMA)报告指南的首选报告项目。在Pubmed和EMBase数据库中进行了系统的文献检索,并于2月15日进行了更新,2023年。搜索词包括\'婴儿\',\'插管\',\'腹腔镜检查\',\'死亡率\',\'严重事件\',“合并症”及其同义词。包括自2000年以来以英文发表的论文,描述了至少50名1岁以下接受腹腔镜手术的患者。当大多数患者患有先天性异常时,文章被排除在外。使用QUIPS偏倚风险工具评估研究质量。
■Pubmed和Embase数据库总共产生了12,401篇独特文章,经过对标题和摘要的筛选,共选择了471篇文章进行全文筛选。十篇文章符合本系统综述的纳入标准,其中包括1778名<1岁的婴儿接受择期腹腔镜手术。死亡率发生过一次(与手术无关的死亡),在53/1778的程序中进行无事件和危重事件的复苏。
■这篇综述的结果表明,在选择性腹腔镜手术期间和之后,没有广泛合并症的婴儿的发病率和死亡率似乎有限,这表明,在该年龄段,对性腺损伤高风险的癌症婴儿进行选择性腹腔镜OTC的优势可能超过腹腔镜手术的麻醉和手术风险。
UNASSIGNED: Infertility is an important late effect of childhood cancer treatment. Ovarian tissue cryopreservation (OTC) is established as a safe procedure to preserve gonadal tissue in (pre)pubertal girls with cancer at high risk for infertility. However, it is unclear whether elective laparoscopic OTC can also be performed safely in infants <1 year with cancer. This systematic
review aims to evaluate the reported risks in infants undergoing elective laparoscopy regarding mortality, and/or critical events (including resuscitation, circulatory, respiratory, neurotoxic, other) during and shortly after surgery.
UNASSIGNED: This systematic
review followed the Preferred reporting Items for Systematic
Review and Meta-Analyses (PRISMA) reporting guideline. A systematic literature search in the databases Pubmed and EMbase was performed and updated on February 15th, 2023. Search terms included \'infants\', \'intubation\', \'laparoscopy\', \'mortality\', \'critical events\', \'comorbidities\' and their synonyms. Papers published in English since 2000 and describing at least 50 patients under the age of 1 year undergoing laparoscopic surgery were included. Articles were excluded when the majority of patients had congenital abnormalities. Quality of the studies was assessed using the QUIPS risk of bias tool.
UNASSIGNED: The Pubmed and Embase databases yielded a total of 12,401 unique articles, which after screening on title and abstract resulted in 471 articles to be selected for full text screening. Ten articles met the inclusion criteria for this systematic
review, which included 1778 infants <1 years undergoing elective laparoscopic surgery. Mortality occurred once (death not surgery-related), resuscitation in none and critical events in 53/1778 of the procedures.
UNASSIGNED: The results from this
review illustrate that morbidity and mortality in infants without extensive comorbidities during and just after elective laparoscopic procedures seem limited, indicating that the advantages of performing elective laparoscopic OTC for infants with cancer at high risk of gonadal damage may outweigh the anesthetic and surgical risks of laparoscopic surgery in this age group.