Ye Xiong, Xie Liang, Chen Gang, Tang Ji-Ming, Ben Xiao-Song
Department of Thoracic Surgery, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China Guangdong Association Study of Thoracic Oncology, Guangzhou, China.
Department of Thoracic Surgery, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
Interact Cardiovasc Thorac Surg. 2015 Oct;21(4):409-14. doi: 10.1093/icvts/ivv155. Epub 2015 Jun 27.
There are two different minimally invasive approaches, robotic thoracic surgery (RTS) and video-assisted thoracic surgery (VATS), which are performed for lung cancer resection. This meta-analysis aimed to compare the perioperative outcomes of RTS with those of VATS for patients with lung cancer.
We searched articles indexed in the PubMed and ScienceDirect databases that met our predefined criteria, published up to January 2015. A meta-analysis was performed by combining the results of reported incidences of perioperative morbidity and mortality. The relative risk (RR) was used as a summary statistic.
Eight eligible articles with 3379 subjects were considered in the analysis (8 articles for morbidity, while 4 articles for mortality). Overall, pooled analysis indicated that perioperative morbidity and mortality were similar between RTS and VATS (morbidity: RR, 1.02; 95% CI, 0.94-1.10; P = 0.605; mortality: RR, 0.28; 95% CI, 0.06-1.25; P = 0.095). No evidence of publication bias was observed.
This meta-analysis showed that RTS resulted in similar outcomes compared with VATS cases. RTS appears to be an appropriate alternative to VATS, which is associated with improved outcomes compared with open thoracotomy. RTS should be studied further in selected centres and compared with VATS in a randomized fashion to better define its potential advantages and disadvantages.
有两种不同的微创方法,即机器人辅助胸外科手术(RTS)和电视辅助胸腔镜手术(VATS),用于肺癌切除术。本荟萃分析旨在比较RTS与VATS治疗肺癌患者的围手术期结果。
我们检索了截至2015年1月在PubMed和ScienceDirect数据库中索引的符合我们预定义标准的文章。通过合并报告的围手术期发病率和死亡率的结果进行荟萃分析。相对危险度(RR)用作汇总统计量。
分析中纳入了8篇符合条件的文章,共3379名受试者(8篇关于发病率,4篇关于死亡率)。总体而言,汇总分析表明,RTS和VATS的围手术期发病率和死亡率相似(发病率:RR,1.02;95%CI,0.94-1.10;P = 0.605;死亡率:RR,0.28;95%CI,0.06-1.25;P = 0.095)。未观察到发表偏倚的证据。
本荟萃分析表明,RTS与VATS病例的结果相似。RTS似乎是VATS的一种合适替代方法,与开胸手术相比,VATS的结果有所改善。应在选定的中心对RTS进行进一步研究,并以随机方式与VATS进行比较,以更好地确定其潜在的优缺点。