| Background& Object:With the development of video-assisted thoracic surgery(VATS),In 2005,oneport video-assisted thoracic surgery was first used by Dr.Gaetano Rocco for simpler intra-thoracic procedures.In addition,the technique facilitates simple intra-thoracic procedures through video-assisted thoracic surgery without using more than one port.Furthermore,one-port VATS had better clinical and economic results compared with three port VATS in the treatment of SP patients.Therefore,thoracic surgeons are particularly concerned about the number and size of surgical incisions.For the surgical treatment of patients with spontaneous pneumothorax,it is still controversial whether one-port VATS can completely replace the three-port VATS in the treatment of SP to achieve the same surgical effect,or even better than the three-port VATS in the treatment of SP in some aspects.The purpose of this meta-analysis was to summarize the available evidence to evaluate the feasibility and advantages of one-port VATS versus three-port VATS for the treatment of SP.Method:In this study,we searched from computers in PubMed,The Cochrane Library,Embase,Web of Science,Science Direct,Ovid Medline database and Google Scholar from January 2005 to July 2019.A comparative study of single-port VATS versus threeport VATS in the treatment of SP was conducted,and the two authors independently screened the literature,extracted the data,and assessed the risk of bias in related studies.Then,we performed Meta analysis using RevMan 5.3 software.Restlus:A total of 731 patients were included in this study,including 364 patients in the single-port VATS group and 367 patients in the three-port VATS group.Meta-analysis results showed that for patients with clinical diagnosis of SP,the postoperative complication rate of single-port VATS and three-port VATS(OR=0.86,95%CI:0.39~1.90,P=0.71)and postoperative pneumothorax recurrence rate(OR=0.50,95%CI:0.22~1.14,P=0.10)were not statistically significant.However,compared with three-port VATS,Shorten operation time(MD=-2.63,95%CI:-5.25~-0.02,P=0.05),Shorter hospital stay(MD=-0.72,95%CI:-0.83~-0.60,P<0.00001),reduce the time of chest tube drainage(MD=-0.42,95%CI:-0.83~-0.01,P=0.04),reduce postoperative skin paresthesia(OR=0.14,95%CI:0.07~0.27,P<0.00001),lower postoperative pain score at 24h(MD=-0.99,95%CI:-01.31~-0.68,P<0.00001),lower postoperative pain score at 72h(MD=-0.43,95%CI:-0.66~-0.19,P=0.0004),improved postoperative satisfaction score at 24h(MD=-0.69,95%CI:-0.73~-0.64,P<0.00001)and improved postoperative satisfaction score at 48h(MD=-0.53,95%CI :-0.57~-0.49,P<0.00001),The difference was statistically significant.Conclusion:In summary,this meta-analysis shows that one-port VATS has the same safety and efficacy as three-port VATS in the treatment of SP,but compared with three-port VATS,one-port VATS has certain advantages in reducing postoperative pain,improving postoperative satisfaction and rapid recovery. |
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