Meta-analysis comparing the perioperative efficacy of single-port versus two and multi-port video-assisted thoracoscopic surgical anatomical lung resection for lung cancer

Abstract

Background: As a new surgical procedure for non-small cell lung cancer, single-port video-assisted thoracoscopic surgery (VATS) has lately gained popularity; nevertheless, it is unknown if single-port VATS offers any advantages over multi-portal. The study aims to assess the different impacts of using single-port VATS versus 2-port or multi-port VATS such as operation and drainage time, blood loss volume, number of resected lymph nodes, and hospital stay in lung cancer patients. Methods: Inclusion criteria included studies from different languages that compare single-port against 2 or multi-port VATS. The outcomes of these studies were analyzed using a random-effect model and it was used to calculate the mean difference with 95 percent confidence intervals to quantify the impact of different surgical techniques on clinical parameters. Results: Single or Uni-portal video-assisted thoracoscopic surgery results in significantly lower drainage time after surgery compared with 2-port (P = .03) and multi-port (P < .001) VATS. In contrast to the resection of lymph nodes, there was no significant difference between uni-port and 2-port (P = .49) or multiport (P = .29) VATS. While operation time, blood loss, complications, and hospital stay were significantly lower in uni-port compared with multi-port VATS (P = .04, P = .002, P < .001, respectively), but not with 2-port VATS (P = .44, 0.06, P = .13). There were no significant differences between uni-port and multi-port VATS regarding conversion rate, mortality, and staging. Conclusion: Single or Uni-portal video-assisted thoracoscopic surgery has high efficacy and lower side effects compared with multi-port regarding the perioperative outcomes. Two-port VATS has similar results with uni-port in several parameters.