Yang Zhang, Shen Zhenghai, Zhou Qinghua, Huang Yunchao
a Department of Thoracic Surgery I , The Third Affiliated Hospital of Kunming Medical University (Yunnan Tumor Hospital) , Kunming , PR China.
b Lung Cancer Center , West China University, Sichuan University , Chengdu , PR China.
Acta Chir Belg. 2018 Apr;118(2):85-93. doi: 10.1080/00015458.2017.1379800. Epub 2017 Sep 21.
Recent studies compared single-incision thoracoscopic surgery (SITS) with more widely used conventional multiport video-assisted thoracoscopic surgery in the treatment of lung cancer. To establish the safety and feasible of SITS in the treatment of lung cancer, we conducted this systematic review and meta-analysis.
Eleven studies were identified from the databases of PubMed, Cochrane Library, SpringerLink, and ScienceDirect. The randomized controlled trials (RCTs) and non-randomized studies evaluated the outcomes of SITS compared with multiport video-assisted thoracoscopic surgery in the treatment of lung cancer were included for analysis. Odds ratio (OR, used to compare dichotomous variables) and weight mean difference (WMD, used to compare continuous variables) were calculated with 95% confidence intervals (CIs) based on intention-to-treat analysis.
Eleven studies including 1314 patients were included for analysis. Our analysis showed that the operative time, blood loss amount, mean duration of chest tube, lymph nodes retrieved were similar between two approaches, the SITS pulmonary resection might be associated with shorter hospital stay (p = .008) and lower complication rate (p = .009) when compared with conventional multiport video-assisted thoracoscopic surgery approaches.
In selected patients SITS is safe, feasible and may be considered an alternative to multiport VATS.
近期研究比较了单孔胸腔镜手术(SITS)与应用更为广泛的传统多孔电视辅助胸腔镜手术在肺癌治疗中的效果。为确定SITS治疗肺癌的安全性和可行性,我们进行了这项系统评价和荟萃分析。
从PubMed、Cochrane图书馆、SpringerLink和ScienceDirect数据库中检索到11项研究。纳入评估SITS与多孔电视辅助胸腔镜手术治疗肺癌效果的随机对照试验(RCT)和非随机研究进行分析。基于意向性分析计算比值比(OR,用于比较二分变量)和加权均数差(WMD,用于比较连续变量)及其95%置信区间(CI)。
纳入11项研究共1314例患者进行分析。我们的分析表明,两种手术方式的手术时间、失血量、胸管留置平均时间、清扫淋巴结数量相似,但与传统多孔电视辅助胸腔镜手术相比,SITS肺切除术可能住院时间更短(p = 0.008),并发症发生率更低(p = 0.009)。
对于特定患者,SITS是安全、可行的,可被视为多孔电视辅助胸腔镜手术的替代方案。