Objective This study has been compared the effectiveness of different surgical methods in the treatment of mitral regurgitation (MR) in adults by using the 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). Stata16.0 and Addis1.16.8 software was used for network meta‐analysis using the Bayesian approach. Results A total of 31 studies were included, 12,998 patients, involving five surgical methods. Network meta‐analysis showed that: in terms of complications (odds ratio [OR]: 0.65, 95% CI: 0.13–3.00, probability rank = 0.37) and MR (OR: 0.03, 95% CI: 0.0–8315, probability rank = 0.64), the 3D‐MVS group had the lowest event rate. In terms of blood transfusion rate (OR: 0.55, 95% CI: 0.16–1.84, 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 This minimally invasive surgery has their own advantages and disadvantages. Overall, 3D‐MVS is most satisfactory, but more samples are needed.

IntroductionAs for coronary artery bypass grafting, although there are many direct comparative studies on different minimally invasive methods and traditional thoracotomy (off-pump/on-pump), there is still a lack of further ranking and summary of the efficacy of all surgical methods for left main coronary artery (LMCA) lesions. Combined with the current controversial views, this study aims to introduce a planned network meta-analysis (NMA) in detail, with a view to comparing the long-term efficacy and safety of multiple therapeutic methods in the treatment of patients with LMCA disease, and finally providing some reference bases for the best selection of clinical schemes.Method and analysisPubMed, Embase, Web of Science and The Cochrane Library databases will be collected from inception to June 2022 to compare the efficacy of different surgical methods in randomised controlled trials (RCTs) for LMCA disease. Main outcome endpoints: major adverse cardiovascular events, including mortality, myocardial infarction, stroke and revascularisation. Secondary outcome endpoints: (1) operation-related time, (2) the amount of blood transfusion, (3) complications including secondary thoracotomy, postoperative new atrial fibrillation, wound infection, (4) physiological score and psychological score, (5) time return to work and (6) total hospitalisation costs. The methodological quality of included RCTs will be assessed according to the Cochrane bias risk table. The Bayesian NMA will be conducted by STATA V.16.0.Ethics and disseminationThe essence of this study is to summarise and analyse the original data without the approval of the ethics committee. Our research does not involve ethical issues, and the results will be published in peer-review journals.PROSPERO registration numberCRD42021274712.

To cite: Huang et al. Safety and efficacy of robotic versus endoscopic atrial septal defect repair: a systematic review and meta-analysis. Inplasy protocol 202140138.