Zhang Lin, Luo Jiwen, Wu Xiaofang
Department of Cardiothoracic Surgery, Mianyang Central Hospital, Mianyang City, 621000, Sichuan Province, China.
Department of Obstetrics and Gynecology, Mianyang Central Hospital, No. 12, Changjia Lane, Jinzhong Street, Fucheng District, Mianyang City, 621000, Sichuan Province, China.
BMC Cancer. 2025 Mar 5;25(1):400. doi: 10.1186/s12885-025-13755-3.
This meta-analysis aims to evaluate the impact of these two techniques on postoperative pain and quality of life in early-stage NSCLC patients.
A comprehensive literature search was conducted in PubMed, Cochrane Library, Web of Science, and CNKI databases. Randomized controlled trials and cohort studies comparing single-port and three-port VATS lobectomy for early-stage NSCLC were included. The primary outcomes were operating time, postoperative complications, and 24-hour postoperative visual analog scale (VAS) pain scores. The Newcastle-Ottawa Scale (NOS) was used to assess study quality. Meta-analysis was performed using random-effects models, and heterogeneity was assessed using the I² statistic.
Fifteen studies involving 3,228 patients (801 in the single-port group and 2427 in the three-port group) were included. The meta-analysis revealed that single-port VATS lobectomy was associated with a longer operating time (SMD: 0.61, 95% CI: 0.29 to 0.93, p < 0.001) compared to the three-port approach. However, single-port VATS demonstrated a lower incidence of postoperative complications (RR: 0.73, 95% CI: 0.59 to 0.90, p < 0.001). There was no significant difference in 24-hour postoperative VAS pain scores between the two groups (SMD: 0.02, 95% CI: -1.41 to 1.45, p > 0.05), although substantial heterogeneity was observed (I² = 98.1%).
This meta-analysis suggests that single-port VATS lobectomy may offer advantages in terms of reduced postoperative complications compared to the three-port approach, despite longer operating times. However, the impact on immediate postoperative pain remains inconclusive due to high heterogeneity among studies.
本荟萃分析旨在评估这两种技术对早期非小细胞肺癌（NSCLC）患者术后疼痛及生活质量的影响。
在PubMed、Cochrane图书馆、科学引文索引数据库及中国知网数据库中进行全面的文献检索。纳入比较单孔与三孔电视辅助胸腔镜肺叶切除术治疗早期NSCLC的随机对照试验和队列研究。主要结局指标为手术时间、术后并发症及术后24小时视觉模拟评分（VAS）疼痛评分。采用纽卡斯尔-渥太华量表（NOS）评估研究质量。使用随机效应模型进行荟萃分析，并使用I²统计量评估异质性。
纳入15项研究，共3228例患者（单孔组801例，三孔组2427例）。荟萃分析显示，与三孔手术相比，单孔电视辅助胸腔镜肺叶切除术的手术时间更长（标准化均数差：0.61，95%置信区间：0.29至0.93，p<0.001）。然而，单孔电视辅助胸腔镜肺叶切除术的术后并发症发生率较低（风险比：0.73，95%置信区间：0.59至0.90，p<0.001）。两组术后24小时VAS疼痛评分无显著差异（标准化均数差：0.02，95%置信区间：-1.41至1.45，p>0.05），尽管观察到显著的异质性（I²=98.1%）。
本荟萃分析表明，与三孔手术相比，单孔电视辅助胸腔镜肺叶切除术在减少术后并发症方面可能具有优势，尽管手术时间较长。然而，由于研究间的高度异质性，对术后即刻疼痛的影响仍不明确。
