| Objective To systematically evaluate the effectiveness and safety of single-incision video-assisted thoracic surgery(VATS)versus conventional multiple ports VATS for Lung Cancer.Methods We searched databases including PubMed,The Cochrane Library(Issue 3,2016),EMbase,CBM,Wan Fang Data and CNKI from inception to Apr.2016,to collect randomized controlled trials(RCTs)and cohort studies comparing single-incision VATS and conventional multiple ports VATS for lung cancer.Two 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 A total of 9 cohort studies involving 1318 patients were finally included.The results of meta-analysis showed that:compared with conventional multiple ports VATS group,single-incision VATS group had shorter chest drainage time(MD= –0.70,95%CI–1.38 to–0.02,P=0.04),shorter hospital stay(MD= –0.52,95%CI–0.91 to–0.14,P=0.007),less amount of intraoperative bleeding(MD= –18.49,95%CI–33.61 to–3.37,P=0.02),lower VAS score of 1,3d-postoperative pain(MD=–0.32,95%CI–0.51 to–0.14,P=0.0007)and(MD= –0.48,95%CI–0.58 to–0.38),P<0.00001).Meanwhile,there were no statistical differences between both groups in operation time(MD= –3.40,95%CI–13.65 to 6.85,P=0.52),the postoperative complications(OR= 0.91,95%CI0.65 to 1.27,P=0.56),the number of lymph node-dissection(MD= –0.79,95%CI–2.35 to 0.77,P=0.32),the total cost(MD= 0.47,95%CI–0.39to1.32,P=0.28),the Intraoperative conversion rate(OR= 0.92,95%CI 0.44 to 1.93,P=0.82)and VAS score of 7d-postoperative pain(MD= –1.18,95%CI–2.42 to 0.07),P=0.06).Conclusion Current evidence shows,single-incision VATS is superior in the surgical trauma to conventional multiple ports VATS in the treatment of lung cancer,However,due to limited quality and quantity of included studies,more large-scale,high-quality studies are needed to verify the above conclusion. |
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