One Port Video Assisted Thoracic Surgery Versus Three Port Video Assisted Thoracic Surgery For Primary Spontaneous Pneumothorx: A Systematic Review And Meta-analysis

ObjectiveTo further understand the effects of video-assisted thoracic surgery(VATS)with one-port versus three-port VATS for primary spontaneous pneumothorax(PSP).MethodsIn this study,we searched information from the Pub Med,Cochrane Library,Embase,Science Direct,Web of Science,China National Knowledge Infrastructure(CNKI),and Wanfang Data databases from inception to September 2015 to collect data of randomized controlled trials(RCTs)and cohort studies about one-port VATS versus three-port VATS for PSP.Two independent authors were committed to screen literature,extract data,and assess the risk of bias of related studies.Then,we used the Rev Man 5.20 software for a meta-analysis of one-port VATS versus three-port VATS for PSP.ResultsSix cohort studies involving 310 patients were finally selected in this meta-analysis.The results of our study indicate that one-port VATS had a shorter hospital stay(MD =-0.39,95 % CI-0.69 to-0.09,P = 0.01),lower VAS score of 24-h post-operative pain(MD =-0.78,95 % CI-1.40 to-0.52,P <0.00001),shorter chest drainage time(MD =-0.68,95 % CI-1.15 to-0.22,P = 0.004),and lower incidence of post-operative paraesthesia(OR=0.13,95 % CI 0.06 to 0.29,P<0.00001)compared with three-port VATS.However,one-port VATS had a lower patient satisfaction score at 24 h(MD =-0.65,95 % CI-0.95 to-0.35,P <0.0001)and 48 h(MD =-0.46,95 % CI-0.71 to-0.21,P = 0.0002).No differences in the recurrence of pneumothorax(OR=0.58,95%CI(0.20,1.67),P=0.32),the operation time(MD=-1.01,95 % CI-4.63 to 2.60,P=0.58),and the satisfaction score at 72 h(MD =-0.11,95 % CI-0.44 to 0.22,P=0.50)were noted between the groups.ConclusionCurrent evidence suggests that one-port VATS may have certain advantages over three-port VATS for PSP.More large-scale and high-quality studies are needed for authentication.