Video-assisted Thoracoscope versus Video-assisted Mini-thoracotomy for Non-small Cell Lung Cancer: A Meta-analysis

Background and objective The aim of this study is to assess the effect of video-assisted thoracoscopic surgery (VATS) and video-assisted mini-thoracotomy (VAMT) in the treatment of non-small cell lung cancer (NSCLC). Methods We searched PubMed, EMbase, CNKI, VIP and ISI Web of Science to collect randomized controlled trials (RCTs) of VATS versus VAMT for NSCLC. Each database was searched from May 2006 to May 2016. Two reviewers independently assessed the quality of the included studies and extracted relevant data, using RevMan 5.3 meta-analysis software. Results We finally identified 13 RCTs involving 1,605 patients. There were 815 patients in the VATS group and 790 patients in the VAMT group. The results of meta-analysis were as follows: statistically significant difference was found in the harvested lymph nodes (SMD=-0.48, 95%CI: -0.80- -0.17), operating time (SMD=13.56, 95%CI: 4.96-22.16), operation bleeding volume (SMD=-33.68, 95%CI: -45.70- -21.66), chest tube placement time (SMD=-1.05, 95%CI: -1.48- -0.62), chest tube drainage flow (SMD=-83.69, 95%CI: -143.33- -24.05), postoperative pain scores (SMD=-1.68, 95%CI: -1.98- -1.38) and postoperative hospital stay (SMD=-2.27, 95%CI: -3.23- -1.31). No statistically significant difference was found in postoperative complications (SMD=0.83, 95%CI: 0.54-1.29) and postoperative mortality (SMD=0.95, 95%CI: 0.55-1.63) between videoassisted thoracoscopic surgery lobectomy and video-assisted mini-thoracotomy lobectomy in the treatment of NSCLC. Conclusion Compared with video-assisted mini-thoracotomy lobectomy in the treatment of non-small cell lung cancer, the amount of postoperative complications and postoperative mortality were almost the same in video-assisted thoracoscopic lobectomy, but the amount of harvested lymph nodes, operating time, blood loss, chest tube drainage flow, and postoperative hospital stay were different. VATS is safe and effective in the treatment of NSCLC.