The long-term impact on pulmonary function via phrenic nerve transfer to the teenager and adult: a Meta-analysis

Objective To evaluate the long-term influence on pulmonary function of the teenager (≥13ys) and adult patients after phrenic nerve transfer and providing guideline for further clinical practice and research. Methods Detailed electronic and hand searches with no restrictions were performed for published paper about phrenic nerve transposition from January, 1970 to January, 2015. The PubMed, Cochrane Library, Embase database, CBM, CNKI database, VIP, Wanfang data were used for published paper searching. For foreign language paper, the key words were. "phrenic nerve trans*" , "respiratory function" , and for Chinese literature searching, the key words were "phrenic nerve, pulmonary function, nerve transfer". The other sources as supplying, such as related references tracing, were also retrieved. The literature was screened according to inclusive criteria, and repeated documents with animal experimental study were excluded. The data were extracted and the quality of included studies was assessed. Meta-analysis was conducted using Review Manager 5.3 software. Results A Total of 208 literatures were retrieved, and ultimately 10 articles met the requirements, including 5 Chinese and 5 English articles with 401 patients. In comparison to preoperative, the pulmonary function of VC, FEV1, RV and FRC after phrenic nerve transfer had no significant difference half a year postoperatively, and also, 1 year postoperatively. However, compared with 1 year after operation, the VC, FEV1 decline ratio of half a year postoperatively decreased significant. Assessment of quality of life related breathing with the St George's respiratory questionnaire score (SGRQ) , compared to the reference values of pulmonary function, except the scores of activities were no significant difference, the total average score, symptoms component scores and the impact components scores were significantly higher. Conclusion The pulmonary function can be recovered to the preoperative level after phrenic nerve transfer half a year postoperatively; the quality of life related respiration is damaged after phrenic nerve transposition. But overall, it is slight injury. Key words: Phrenic nerve; Pulmonary function; Long-term effects; Meta-analysis