Efficacy Of Thoracoscopy Versus Thoracotomy For Spontaneous Spneumothorax :a Meta-analysis

Objectives: To systematically review the clinical effects and safety of thoracoscopy operation and thoracotomy for spontaneous pneumothorax. Methods: We We searched PubMed, EMbase, The Cochrane Library(Issue 10,2013), Web of Knowledge, CNKI, CBM, WanFang Data and VIP up to October 2013. Randomized controlled trials involving treatment outcomes of spontaneous pneumothorax using thoracoscopy compared with thoracotomy were included. Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted data, and assessed the methodological quality of the included studies. Then RevMan 5.2 software was used for meta-analysis. Results: A total of 7 studies involving 481 patients were included. The results of meta-analysis showed that the operative time in the thoracoscopy goup was significantly longer than that in the thoracotomy group(MD=13.57, 95%CI 3.58 to 23.56, P=0.008). But there was no significant difference in recurrence rates(RR=3.16, 95%CI 0.84 to 11.94, P=0.09), total postoperative complications(RR=1.33, 95%CI 0.46 to 3.88, P=0.46), postoperative chest drainage time(MD= –0.00, 95%CI –0.64 to –0.63, P=0.99), and hospitalization time(MD=0.09, 95%CI –0.21 to 0.40, P=0.55). Conclusion Compared with thoracotomy, thoracoscopy does not increase recurrence rates, postoperative complications, chest drainage time or hospitalization time, but it could prolong operation time in a certain extent.