| Aims:To evaluate robot-assisted thoracic surgery(RATS)and video-assisted thoracic surgery(VATS)safety and effectiveness for early non-small cell lung cancer(NS CLC).And to compare the short-term and long-term therapeutic effects for NSCLC between RATS and VATS.Methods:We searched articles about Robot-Assisted Surgery(RATS)and video-assisted thoracic surgery(VATS)in the treatment of early non-small cell lung cancer(NS CLC),which published in the databases Web of Science,Pub Med,Embase,CNKI,Wanfang Database from 1/1/2019 to 31/12/2020.Two researchers separately retrieved and screened the literature,and independently extracted literature data and evaluated the risk of research bias.If the results of the two researchers conflict,the third researcher will conduct a literature review to determine whether to include the study.Meta analysis uses Rev Man 5.3 software for analysis,in which the Odds ratio(OR)is used as the effect indicator for the count data,and the Weighted Mean Difference(WMD)is used as the effect indicator for the measurement data.Each effect size is given its Point estimate and 95% CI.Results:After searching the database,1178 original studies were screened,and finally included 10 retrospective clinical studies that were in line with the design of this study.The number of cases was 33,972.Among them,the Da Vinci robot-assisted thoracic surgery(RATS)group was included.The total number of cases included was10358,and the total number of cases included in the video-assisted thoracic surgery(VATS)group was 23614 cases.After analysis,it was found that the gender composition,age,surgical transition rate of the included cases(OR=1.17,95%Cl:0.43～3.15,P=0.76),operation time(MD=16.02,95% Cl:-14.22～46.26,P =0.30),tumor diameter(MD=-0.04,95% Cl:-0.18～0.11,P=0.61),number of dissected lymph nodes(MD=0.06,95% Cl:-0.42～0.53,P=0.81),Postoperative complications(OR=0.92,95% Cl : 0.71～1.19,P=0.02)surgery Posterior lung infection(OR=1.01,95%Cl:0.74～1.39,P=0.94),postoperative cardiovascular complications(OR=4.88,95%Cl:0.18～49.51,P=0.18),closed thoracic drainage Time(MD=-0.30,95%Cl:-0.78～0.17,P=0.21),postoperative hospital stay(MD=-0.64,95%Cl:-1.32～0.03,P=0.06),number of postoperative recurrences(OR=0.46,95% Cl :0.18～1.15,P=0.10),There is no difference between the Da Vinci robot-assisted thoracic surgery(RATS)group and the video-assisted thoracic surgery(VATS)group.The amount of blood loss in the robot-assisted thoracic surgery(RATS)group was comparable to that in the video-assisted thoracic surgery(VATS)group,but the research and analysis with strong xenophobic heterogeneity found that the amount of blood loss was as high as that in the video-assisted thoracic surgery(VATS)group.The amount of bleeding in the robot-assisted thoracic surgery(RATS)group was less than that in the video-assisted thoracic surgery(VATS)group(MD=-49.15,95% Cl was-57.85～-40.45,p<0.00001).Conclusion:Ordinary video-assisted thoracic surgery(VATS)and Da Vinci robotic system-assisted surgery(robot-assisted thoracic surgery,RATS)have the same long-term curative effect in the surgical treatment of early stage non-small cell lung cancer.However,Da Vinci robot-assisted thoracic surgery(RATS)has a lower amount of intraoperative blood loss,which also confirms the previous view that robot-assisted thoracic surgery is believed to be able to effectively reduce the amount of surgical blood loss.Since the included studies are all retrospective analysis and limited by quantity and quality,the above conclusions still need to be verified by more high-quality prospective studies. |
PDF Full Text Request