ObjectiveTo evaluate the clinical efficacy of central venous catheter closed drainage of pleural cavity combined with negative pressure suction in the treatment of spontaneous pneumothorax. MethodsThe randomized controlled trials(RCTs) on central venous catheter closed drainage of pleural cavity combined with negative pressure suction in the treatment of spontaneous pneumothorax were searched in PubMed, OVID, CNKI, Wangfang database, Super Star Digital Library, CMB, Baidu and Google search engines. The searching time was from the time of building database to September 15, 2014. Two searchers selected studies based on the included criteria strictly. The quality of RCTs was appraised by the criteria of Cochrane Collaboration. RevMan5.3 software was used for data analysis and management. ResultsA total of 18 RCTs including 1 549 patients were identified. There were no statistical differences in time of lung recruitment (SMD=0.01 and 95%CI -0.23 to 0.25, P=0.95), time of hospital stay (SMD=-0.42, 95%CI -1.81 to 0.97, P=0.55), curative resection rate (RR=1.04 and 95%CI 1.00 to 1.08, P=0.07) between the two groups. The rate of complications in the central venous catheter group was less than that in the conventional pleural cavity closed drainage group with a statistical difference (RR=0.31, 95%CI 0.23 to 0.43, P<0.000 01). ConclusionThe treatment of central venous catheter closed drainage of pleural cavity combined with negative pressure suction for spontaneous pneumothorax is a simple and safe operation. However, the quality of studies included is not high and some sample size is small. RCTs with large sample of high quality are still needed for further confirmation.
ObjectiveTo evaluated the effect of the video-assisted thoracoscope surgery(VATS) for non-small cell lung cancer. MethodsWe searched EMbase, PubMed, OVID, Springer Link, Cochrane Library, CNKI, CBMdisc, and VIP to collect randomized controlled trials(RCTs) of VATS versus thoracotomy for non-small cell lung cancer. Each database was searched from establishment to October 2014. Two reviewers independently assessed the quality of the included studies and extracted relevant data, using RevMan5.3 meta-analysis software. ResultsWe finally identified 10 RCTs involving 1 529 patients. There were 453 patients in the VATS group and 1 076 patients in the thoracotomy group. The results of meta-analysis showed that there was no statistical difference in the number of lymph node dissection(P=0.41), operation time(P=0.14), operation bleeding volume(P=0.14), chest tube placement time(P=0.53), operation mortality(P=0.72), and the overall survival rate(P=0.39). While there were statistical differences in thoracic drainage(P=0.04), post-operation hospital stay(P=0.01), and postoperative complications(P=0.0001). ConclusionVATS is safe and effective in the treatment of non-small cell lung cancer.