Single-incision Versus Biportal Video-assisted Thoracoscopic Surgery In The Treatment Of Lung Cancer: A Meta-analysis

Objective: In recent years,with the development of new surgical techniques and instruments,more and more thoracic surgeons regard single port VATS as a feasible choice.However,for lung cancer,it is still unknown whether single-incision video-assisted Thoracoscopic surgery has more potential advantages than biportal.We conducted this Meta-analysis to compare the perioperative efficacy of their anatomical lobectomy for lung cancer.Methods : By searching CNKI,CBM,VIP,Wanfang,Cochrane Library,Pub Med,EMBASE and other databases,we searched and compared the literature of single-port thoracoscopy and biportal thoracoscopy in the treatment of lung cancer.Meta-analysis was performed with Review Manager 5.3 software to evaluate related indexes of the operation time,intraoperative hemorrhage,number of lymph node dissection,time of thoracic tube retention,incidence of postoperative complications,postoperative hospital stay,postoperative visual analogue pain score(VAS).Results: Finally,15 related research literatures were included,including 14 Chinese literatures and 1 English literature.There were 1643 patients,including 782 patients with single-incision and 861 patients with biportal.The Meta-analysis results showed that there was no statistical significant difference between the two groups in the operation time(MD = 5.08,95% CI:-7.23 ? 17.40,P = 0.42>0.05),intraoperative hemorrhage(MD =-7.47,95% CI:-16.55 ? 1.61,P = 0.11> 0.05),number of lymph node dissection(MD = 0.22,95% CI:-0.34? 0.78,P = 0.44> 0.05),time of thoracic tube retention(SMD =-0.07,95% CI:-0.17?0.04,P=0.21>0.05)and the incidence of postoperative complications(MD = 0.96,95% CI: 0.72 ? 1.27,P = 0.76>0.05);complications(MD = 0.96,95% CI: 0.72 ? 1.27,P = 0.76>0.05);there was statistical significant difference between the two groups in Postoperative hospital stay(MD =-0.74,95% CI:-1.38 ?-0.09,P = 0.03<0.05),VAS score at the first day after operation(MD =-0.99,95% CI:-1.67 ?-1.32,P = 0.004 <0.05),VAS score at the third day after operation(MD =-0.51,95% CI:-0.99 ?-0.04,P = 0.04 <0.05)and VAS score at first month after operation(MD =-0.26,95% CI:-0.36 ?-0.15,P = 0.00001).Conclusions: For the surgical treatment of lung cancer,it can be considered that single-incision video-assisted Thoracoscopic surgery has a certain advantage in shortening the postoperative hospitalization time and reducing postoperative pain compared with biportal.However,due to the limited quality and quantity of the included studies,the above conclusions need to be verified by more high-quality and large sample literatures.