Compare The Recent Clinical Efficacy Of The Thoracoscopic Segmentectomy And The Thoracoscopic Lobectomy For Early-stage Non-small Cell Lung Cancer: A Systematic Review

Objective:To systematically evaluate the recent clinical effects of thoracoscopic segmentectomy versus thoracoscopic lobectomy for early-stage non-small cell lung cancer.Methods Retrieve based on computer Pub Med,The Cochrane Library,Embase,Chinese biological and medical database(CBM),Chinese Journal Full-text Database(CNKI)and WanFang Data from inception to March 2017,to collect randomized controlled trials(RCTs)and cohort studies comparing thoracoscopic segmentectomy and thoracoscopic lobectomy for early-stage non-small cell lung cancer.Three reviewers independently screened literature,extracted data and assessed the risk of bias of included studies.Then,RevMan 5.3 software was used for meta-analysis.Results:Altogether 13 cohort studies were selected,including 1585 cases,among which 654 cases were in the treatment group and 931 cases in the control group.The results of meta-analysis showed that: compared with the thoracoscopic lobectomy group,the thoracoscopic segmentectomy group had less amount of intraoperative bleeding(SMD=–0.90,95%CI–1.49 to–0.31,P<0.05),shorter chest drainage time(MD=-0.59,95%CI–0.89 to–0.62,P<0.05),less postoperative drainage volume(SMD=–1.91,95%CI–3.19 to–0.62,P<0.05),shorter hospital stay(MD=–1.14,95%CI–1.81 to–0.48,P<0.05),smaller dropping rate of the postoperative FEV1%(MD=–7.56,95%CI–9.63 to–19.97,P<0.05),smaller dropping rate of the postoperative MVV%(MD=–3.79,95%CI –7.49 to–0.10,P<0.05).Meanwhile,there were no statistical differences between both groups in operation time(MD=–0.84,95%CI–11.25 to 12.93,P>0.05),the postoperative complications(OR= 0.85,95%CI 0.56 to 1.28,P>0.05).Conclusion:Current evidence shows,Short-term curative effects of both surgeries were equivalent,but the thoracoscopic segmentectomy group had less amount of intraoperative bleeding,shorter chest drainage time,less postoperative drainage volume,shorter chest drainage time,shorter hospital stay,smaller dropping rate of the postoperative FEV1% and MVV% while its operation time and postoperation complications could match with those of the thoracoscopic lobectomy group.However,due to the limited quality and quantity of included studies,more large-scale,high-quality studies are needed to verify the above conclusion.