Single-port Video-assisted Thoracoscopic Surgery Versus Three-port Video-assisted Thoracoscopic Surgery For Spontaneous Pneumothorax: A Meta-analysis

Objective: Whether single-port video-assisted thoracoscopic surgery is beneficial for spontaneous pneumothorax is inconclusive.This meta-analysis was designed to evaluate the feasibility and advantages of single-port video-assisted thoracoscopic surgery and three-port video-assisted thoracoscopic surgery in the treatment of spontaneous pneumothorax.Methods: We searched the PubMed,Embase,The Cochrane Library,CNKI,and Wanfang databases.We collected randomized controlled trials and retrospective cohort studies of single-port video-assisted thoracoscopic surgery and three-port videoassisted thoracoscopic surgery for spontaneous pneumothorax.Screening literature,extracting data and evaluating the methodological quality of the included studies,statistical analysis was performed using STATA12.0 software and RevMan5.3 software.Results: A total of 11 randomized controlled trials and 28 retrospective cohort studies were included in a total of 2835 patients.A meta-analysis of the randomized controlled trial and the retrospective cohort study respectively showed that compared with the three-port video-assisted thoracoscopic surgery,the single-port video-assisted thoracoscopic surgery had less blood loss during spontaneous pneumothorax surgery [randomized controlled trial Old age group P<0.001;retrospective cohort study P=0.001],shorter thoracic drainage time [randomized controlled trial P <0.001;retrospective cohort study P <0.001],lower pain VAS score 24 hours postoperatively [retrospective cohort study P <0.001 ],72-hour postoperative pain VAS score was lower [retrospective cohort study P <0.001],and the incidence of postoperative skin paresthesia was lower [randomized controlled trial P <0.001;retrospective cohort study P <0.001],length of stay [ Retrospective cohort study P <0.001].However,at the time of surgery [randomized controlled trial P = 0.251;retrospective cohort study P = 0.061],48 hours postoperative pain VAS score [retrospective cohort study P = 0.318] and postoperative pneumothorax recurrence rate [randomized controlled trial P = 0.173;retrospective cohort study P = 0.071],the difference was not statistically significant.Conclusion: Our Meta-analysis shows that the use of s single-port video-assisted thoracoscopic surgery for spontaneous pneumothorax is safe,feasible,and advantageous compared to three-port video-assisted thoracoscopic surgery,which may be a better choice in the future.