Objective To evaluate whether minimally invasive (MI) cardiac surgery has advantages over conventional median sternotomy (MS), so as to provide evidence for clinical diagnosis and therapy.
Methods We searched CBM, VIP, CNKI, PubMed, and Elsevier databases from 1995 through 2008. The literature about the therapeutic effect of minimally invasive cardiac surgery and conventional median sternotomy was identified. The data was extracted, and the methodological quality was evaluated by two reviewers independently. The Meta-analyses were performed using RevMan 4.2 software.
Results A total of 8 studies involving 492 MI patients and 712 MS patients met the inclusion criteria. Of these eight studies, two studies were randomized trials and the other six studies were retrospective cohort studies. The results of meta-analyses showed that the MI group had a better postoperative effect, and the cardiopulmonary bypass time (WMD=16.45, 95%CI 2.56 to 30.35, P=0.02), chest-tube drainage (WMD= –132.63, 95%CI –208.53 to –56.72, P=0.0006) and hospitalization stay (WMD= –1.22, 95%CI –2.14 to –0.30, P=0.009) of MI group were less than those of MS group, but the aorta clamping time (WMD=0.47, 95%CI –1.35 to 2.29, P=0.61) and operating time (WMD=26.67, 95%CI –8.91 to 62.25, P=0.14) were not significantly different between the two groups.
Conclusion The minimally invasive cardiac surgery has a better postoperative therapeutic effect than conventional median sternotomy cardiac surgery.
Citation： YIN Liang,WANG Zhinong,WANG Yifeng,WANG Wentao,JI Guangyu,YANG Xinwei,XU Zhiyun. Cardiac Surgery Via Minimally Invasive Incision versus Median Sternotomy: A Systematic Review. Chinese Journal of Evidence-Based Medicine, 2009, 09(8): 849-854. doi: 10.7507/1672-2531.20090150 Copy