Comparative efficacy of 5 surgical methods in the treatment of mitral
regurgitation: a systematic review and network meta-analysis
Objective This study has been compared the effectiveness of different
surgical methods in the treatment of mitral regurgitation (MR) in adults
by using network meta-analysis method, so as to provide reference for
clinical selection of the best surgical scheme. Methods The PubMed,
EMBASE, the Cochrane Library, CNKI and Chongqing VIP Information
databases were comprehensively searched until December 2020. We
collected retrospective comparative studies on surgical procedures
including 3D endoscopic mitral valve surgery(3D-MVS), robot assisted
mitral valve surgery(R-MVS); totally thoracoscopic mitral valve
surgery(T-MVS), small incision mitral valve surgery (M-MVS) and
traditional thoracotomy mitral valve surgery(C-MVS). Addis1.16.8
software was used for network meta-analysis. Results A total of 31
studies were included, 12998 patients, involving 5 surgical methods.
Network Meta analysis showed that: in terms of complications (OR: 0.65,
95% CI: 0.13 to 3.00, probability rank = 0.37) and mitral regurgitation
(OR:0.03, 95%CI: 0.0 to 8315, probability rank=0.64), the 3D-MVS group
had the lowest event rate. In terms of blood transfusion rate (OR: 0.55,
95% CI: 0.16 to 1.84, probability rank=0.45), T-MVS had the lowest
event rate. In addition, with the exception of operation time and chest
drainage, the R-MVS group has the best curative effect. Conclusion These
minimally invasive surgery has their own advantages and disadvantages.
Overall, 3D-MVS is most satisfactory, but more samples are needed.