Davidson, J;
Kumar, S;
Franklin, D;
Eaton, S;
Curry, J;
De Coppi, P;
Mohammadi, B;
... Abbassi-Ghadi, N; + view all
(2020)
Fundoplication to preserve allograft function after lung transplant: Systematic review and meta-analysis.
Journal of Thoracic and Cardiovascular Surgery
, 160
(3)
pp. 858-866.
10.1016/j.jtcvs.2019.10.185.
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Abstract
Background: ARS has been adopted in select patients with lung transplant for the past 2 decades inmany centers. Outcomes have been reported sporadically. No pooled analysis of retrospective series has been performed. Objective: This review and pooled analysis sought to demonstrate objective evidence of improved graft function in lung transplant patients undergoing antireflux surgery (ARS). Methods: In accordance with Meta-analyses of Observational Studies in Epidemiology guidelines, a search of PubMed Central, Medline, Google Scholar, and Cochrane Library databases was performed. Articles documenting spirometry data pre- and post-ARS were reviewed and a random-effects model meta-analysis was performed on forced expiratory volume in 1 second (FEV1) values and the rate of change of FEV1. Results: Six articles were included in the meta-analysis. Regarding FEV1 before and after ARS, we observed a small increase in FEV1 values in studies reporting raw values (2.02 ± 0.89 L/1 sec vs 2.14 ± 0.77 L/1 sec; n = 154) and % of predicted (77.1% ± 22.1% vs 81.2% ± 26.95%; n = 45), with a small pooled Cohen d effect size of 0.159 (P = .114). When considering the rate of change of FEV1 we observed a significant difference in pre-ARS compared with post-ARS (–2.12 ± 2.76 mL/day vs +0.05 ± 1.19 mL/day; n = 103). There was a pooled effect size of 1.702 (P = .013), a large effect of ARS on the rate of change of FEV1 values. Conclusions: This meta-analysis of retrospective observational studies demonstrates that ARS might benefit patients with declining FEV1, by examining the rate of change of FEV1 during the pre- and postoperative periods.
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