A Meta-analysis Of The Efficacy Of Robotic-assisted Thoracic Surgery And Video-assisted Thoracic Surgery In The Treatment For Lung Cancer

Objective:Evidence-based medicine was used to systematically evaluate the efficacy(safety and effectiveness)of Da Vinci robotic assisted thoracic surgery RATS and video-assisted thoracic surgery VATS for the treatment of lung cancer.Mehtods:To formulate the retrieval strategy,the language of relevant Chinese databases(CNKI,VIP,Wan Fang date)and English databases(Pub Med,EMbase,The Cochrane Library)shall be limited to Chinese or English,and the retrieval time shall be set up until January 2020.According to the inclusion and exclusion Criteria,the quality of included literature was evaluated one by one,and meta-analysis was conducted by Rev Man 5.3 software.Results:A total of 15 references were included,including 1876 patients(817 in RATS group and 1056 in VATS group;9 Chinese literatures and 6 English literatures.)Meta results suggested that RATS had move lymph nodes removed(MD=2.88 95%[1.05,4.70] P<0.00001)? RATS had more lymph node dissection stations(MD=0.5795%[0.06,1.09] P=0.03)?RATS had less bleeding MD=-60.02 95%[-94.76,-25.28]P<0.00001?RATS had more operation time(MD=28.21 95%[8.30,48.11] P=0.005?there are no statistically significant difference in postoperative death between RATS and VATS(RD=-0.01 95%[-0.02,0.01] P=0.30)? there are no statistically significant difference in postoperative complication between RATS and VATS(OR=1.13 95%[0.84,1.53] P=0.42)?there are no statistically significant difference in postoperative transferred to thorax during operation between RATS and VATS(RD=-0.02 95%[-0.05,0.01] P=0.22)? there are no statistically significant difference in postoperative hospital stay between RATS and VATS(MD=-0.4395%[-1.22,-0.35] P=0.28)Conclusions:RATS increased the number of lymph node and lymph node station cleanedin compared to VATS,and decreased the amount of blood loss,but with more lymph nodes dissection,RATS operation time increased.There was no significant difference in intraoperative thoracotomy,postoperative death,postoperative complications and postoperative hospital stay.