Single-incision versus biportal video-assisted thoracoscopic surgery for lung cancer: A Meta-analysis

Objective: To systematically evaluate the effectiveness and safety of single-incision video-assisted thoracoscopic surgery (VATS) versus biportal VATS for lung cancer. Methods: Comparative studies on the treatment of lung cancer by single-incision VATS vs biportal VATS published from database establishment to October 1, 2017 were searched by computer retrieval of PubMed, The Cochrane Library, Embase, VIP database, Chinese Journal Full-text Database, Chinese BioMedical Literature on disc and Wanfang database. Two reviewers independently screened literatures and extracted data. RevMan 5.3 software was used for Meta-analysis. Results: A total of 10 studies (4 prospective studies and 6 retrospective studies) were included, including 1 234 patients. Meta-analysis results showed that pleural drainage time in single-incision VATS for lung cancer was shorter (P < 0.001), postoperative hospitalization time was shorter (P = 0.040), amount of intraoperative bleeding was less (P = 0.007), and Visual Analogue Scale (VAS) scores on d 1, d 3 and d 7 after surgery were lower (P < 0.001, P = 0.020, P = 0.009); but the operation time (P = 0.850), postoperative pleural total drainage (P = 0.080), the number of resected lymph nodes (P = 0.200), the size of resected tumor lesion (P = 0.140) and the rates of postoperative complications (P = 0.380) were not significantly different between two groups. Conclusion: Current evidences show that single-incision VATS has a certain advantage in the treatment of lung cancer than biportal VATS in reducing surgical trauma. Limited by the quantity and quality of the studies, more large-scale and multi-center long-term follow-up studies are still needed to verify the above conclusion. DOI:10.3781/j.issn.1000-7431.2018.33.726