Abstract
Abstract
Objective
We reviewed the available literature on patients with lung cancer undergoing either uniportal (UVATS) or multiport video-assisted thoracoscopic surgery (MVATS).
Methods
Original research studies that evaluated perioperative and long-term outcomes of UVATS versus MVATS were identified, from January 1990 to April 2020. The perioperative, along with the oncologic and long-term survival outcomes, were calculated according to either a fixed or a random effect model, appropriately. The Q statistics and I2 statistic were used to test for heterogeneity among the studies.
Results
Twenty studies were included, incorporating a total of 1,469 patients treated with UVATS and 3,231 treated with MVATS. The incidence of complications was lower in patients treated with UVATS [OR: 0.76 (95% CI 0.62, 0.93); p = 0.008]. The chest tube duration was significantly lower in the UVATS group (WMD: − 0.63 [95% CI − 1.03, − 0.23]; p = 0.002). Length of hospital stay (L.O.S.) was also lower in the UVATS patient group (WMD: − 0.54 [− 0.94, − 0.13]; p = 0.009), along with postoperative pain [WMD: − 0.57 (95% CI − 0.97, − 0.18); p = 0.004]. No significant differences were found regarding the mean operative time (M.O.T.), mean blood loss, the number of resected lymph nodes, the 30-day mortality, along with the survival at 1 and 3 years postoperatively.
Conclusions
The present meta-analysis indicates that UVATS is associated with enhanced outcomes in patients undergoing surgery for lung cancer. Well-designed, randomized studies, comparing UVATS to MVATS, are necessary to further assess their long-term clinical outcomes.
Publisher
Springer Science and Business Media LLC
Subject
Pulmonary and Respiratory Medicine
Reference33 articles.
1. Cao C, Frick AE, Ilonen I, McElnay P, Guerrera F, Tian DH et al (2018) European questionnaire on the clinical use of video-assisted thoracoscopic surgery. Interact CardioVasc Thorac Surg 27:379–383
2. Gonzalez-Rivas D, Fieira E, Delgado M, Mendez L, Fernandez R, de la Torre M (2014) Evolving from conventional video-assisted thoracoscopic lobectomy to uniportal: the story behind the evolution. J Thorac Dis 6:S599-603
3. Falcoz PE, Puyraveau M, Thomas PA et al (2016) Video-assisted thoracoscopic surgery versus open lobectomy for primary non-small-cell lung cancer: a propensity matched analysis of outcome from the European Society of Thoracic Surgeon database. Eur J Cardiothorac Surg 49:602–609
4. Rocco G, Martin-Ucar A, Passera E (2004) Uniportal VATS wedge pulmonary resections. Ann Thorac Surg 77:726–728
5. Salati M, Brunelli A, Rocco G (2008) Uniportal video-assisted thoracic surgery for diagnosis and treatment of intrathoracic conditions. Thorac Surg Clin 18:305–310
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