The single-incision versus multiple-incision video-assisted thoracoscopic surgery in the treatment of lung cancer: A systematic review and meta-analysis

X Zhang, Q Yu, D Lv

Indian Journal of Cancer 2017 54(1):291-300

OBJECTIVE: We conducted this meta-analysis to compare the clinical outcomes of single-incision and multiple-incision video-assisted thoracoscopic surgery (VATS) lobectomy for lung cancer patients. METHODS: A literature search was conducted of the Cochrane Controlled Trials Register Databases, Medline, EMBASE, Web of Science databases, and Chinese Biomedical Literature Database. Eleven studies that compared single-incision VATS with multiple-incision VATS in the treatment of lung cancer were analyzed. Statistical analysis was carried out using RevMan 5.1 software. RESULTS: Eleven trials totaling 1273 patients were included. There were statistically significant differences in the duration of chest tube (standardized mean difference [SMD] = −0.42; 95% confidence interval [CI] [−0.78, −0.07], P < 0.02), hospital stays after surgery (SMD = −0.28; 95% CI [−0.41, −0.15], P < 0.0001), hospital stays after surgery in the subgroup analysis of lobectomy (SMD = −0.28; 95% CI [−0.42, −0.14], P < 0.0001), length of wound (P < 0.05), and pain visual analog scale (VAS) in the postoperative 1 day (SMD = −1.19; 95% CI [−1.94, −0.44], P = 0.002) between single-incision VATS group and multiple-incision VATS group. Compared with patients receiving multiple-incision VATS group, there were no statistically significant differences between the two groups with regard to the operative time (OT), blood loss (BL), rate of conversion to thoracotomy, and complication. CONCLUSION: Compared with multiple-incision VATS on the condition of same lymph nodes retrieved number, single-incision VATS reduced the length of wound, shortened the duration of chest tube, cut down the hospital stays after surgery, alleviated the pain VAS in the postoperative 1 day, did not significantly increase the OT and the BL in operation, and did not increase the rate of conversion to thoracotomy and complication.

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