Subxiphoid Video Thoracoscopic Surgery And Conventional Video Thpracoscopic Surgery For Lung Disease:A Meta-Analysis

To evaluate the short-term efficacy and safety of subxiphoid vid eo thoracoscopic surgery(SVATS)and conventional video thoracosc opic surgery(CVATS)for lung lesion resection.Methods: We searc hed PubMed,the Cochrane Library,EMBASE,CNKI,WanFang and W eiPu to collect the datas of SVATS versus CVATS.The search rang e was from the initial time of database establishment to November2019.Include Case Control study of lung resection(wedge resection,lung segmentectomy,lobectomy)for SVATS and CVATS,and eva luate the quality of the included literature according to the Newcast le-Ottawa Scale(NOS)recommended by the Cochrane Collaboration.Stata 15.0 software performs data analysis and processing.Results:Ten articles were included in the literature,including 7 articles of bullae(wedge resection),and 3 articles of other surgical methods(pulmonary segmentectomy and lobectomy).885 patients were inclu ded.Meta analysis results show that: SVATS and CVATS two surgical methods during the operation blood loss [WMD =-5.50,95%CI(-13.48,2.49),P = 0.177> 0.05],postoperative chest closed drai nage tube placement time [WMD =-0.30,95% CI(-0.73,0.13),P= 0.168> 0.05],average postoperative hospital stay [WMD =-0.53,95% CI(-1.34,0.28),P = 0.200> 0.05] There was no significant difference in the incidence of postoperative complications [OR = 0.72,95% CI(0.46,1.12),P = 0.142> 0.05].The operation time of SVATS operation was significantly longer than that of CVATS grou p [WMD = 10.06,95% CI(0.94,19.17),P <0.05].After total drai nage [WMD =-18.74,95% CI(-35.61,-1.87),P = 0.030 <0.05],p ain score on the first day after surgery [WMD =-1.03,95% CI(-1.51,-0.56),P = 0 <0.05],pain score on the second postoperative day [WMD =-1.70,95% CI(-2.68,-0.71),P = 0.001 <0.05],pain score on the third postoperative day [WMD =-1.78,95% CI(-3.05,-0.51),P = 0.006 <0.05] and postoperative incision numbness [O R = 0.13,95% CI(0.05,0.35),P = 0 <0.05] and other indicators,The SVATS group was better than the CVATS group.Conclusion: S VATS is safe and feasible for lung lesion resection.It has the abilit y to simultaneously treat bilateral lung lesions,wider surgical field of vision,avoid bilateral chest wall incisions,reduce the number of surgical incisions,make the surgical incision more beautiful,and r educe the incidence of incision numbness.Advantage.In view of the low overall sample size and quality of the included literature,it i s recommended to conduct more high-quality prospective cohort stu dies with large multi-center large samples in the future to provide more powerful evidence.