■两个盛行,完全可植入的静脉接入端口通常用于肿瘤学:胸部端口或手臂端口。进行了系统评价和荟萃分析,以比较两种技术的安全性和效率。
■我们从PubMed集中进行了证据获取,Embase,科克伦图书馆确定了评估两种技术的可用比较研究。感兴趣的结果包括总并发症事件,手术相关感染,血栓形成,术中并发症,机械性并发症,转化率,早期港口拆除,和操作时间。
■13项比较研究,包括3,896例患者(2,176例用于胸口,和1,720臂端口)被确定。本研究表明,上臂端口与较高的手术转换率相关(胸口组为2.51%,上臂端口组为8.32%;奇数比[OR]0.27,95%置信区间[CI]0.15-0.46;p<0.001),但是术中并发症的发生率较低(胸口组为1.38%,臂口组为0.41%;OR2.38,95%CI1.07-5.29;p=0.03)。总并发症事件没有组间差异,手术相关感染,血栓形成,机械性并发症,早期港口拆除,和操作时间。60岁以下患者的亚组分析显示,术中事件没有显着差异(胸口组1.19%,臂口组0.02%,OR2.59,95%CI0.74-9.08;p<0.14),表明年龄可能是术中事件的危险因素。敏感性分析没有改变所有感兴趣的终点的结论。
■手臂端口与更高的程序转换率相关联,但是术中并发症的发生率较低,年龄可能是术中事件的危险因素。
UNASSIGNED: Two prevailing, totally implantable venous access ports are routinely utilized in oncology: chest port or arm port. This systematic review with meta-analysis was conducted to compare safety and efficiency of the two techniques.
UNASSIGNED: We performed evidence acquisition intensively from PubMed, Embase, and Cochrane Library. Available comparative studies that evaluated both techniques were identified. The outcomes of interest included total complication events, procedure-related infections, thrombosis, intra-operative complications, mechanical complications, conversion rate, early port removal, and operating time.
UNASSIGNED: Thirteen comparative studies including 3,896 patients (2,176 for chest ports, and 1,720 for arm ports) were identified. The present study showed that arm port was associated with higher procedure conversion rate (2.51% in chest port group and 8.32% in arm port group; odd ratios [OR] 0.27, 95% confidence interval [CI] 0.15-0.46; p<0.001), but lower incidence of intra-operative complications (1.38% in chest port group and 0.41% in arm port group; OR 2.38, 95% CI 1.07-5.29; p=0.03). There were no between-group differences with respect to total complication events, procedure-related infections, thrombosis, mechanical complications, early port removal, and operating time. Subgroup analysis of patients under 60 years revealed that no significant difference was detected in intra-operative events (1.19% in chest port group and 0.02% in arm port group, OR 2.59, 95% CI 0.74-9.08; p<0.14), indicating that age may be a risk factor for intra-operative events. Sensitivity analysis did not change conclusions of all endpoints of interest.
UNASSIGNED: Arm port is associated with higher procedure conversion rate, but lower incidence of intra-operative complications, and age may be a risk factor for intra-operative events.