Da-Vinci robot-assisted thoracic surgery versus video-assisted thoracic surgery for non-small cell lung cancer: A systematic review and meta-analysis
- VernacularTitle:达芬奇机器人与电视辅助胸腔镜手术治疗非小细胞肺癌的系统评价与Meta分析
- Author:
Weiqiang ZENG
1
;
Yunjiu GOU
2
;
Xiangdou BAI
1
Author Information
1. The First Clinical Medical College of Gansu University of Chinese Medicine, Lanzhou, 730000, P. R. China
2. Department of Thoracic Surgery, Gansu Provincial Hospital, Lanzhou, 730000, P. R. China
- Publication Type:Journal Article
- Keywords:
Da-Vinci robot-assisted thoracic surgery;
video-assisted thoracic surgery;
lung cancer;
systematic review/meta-analysis
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2023;30(03):447-457
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare the surgical efficacy of Da-Vinci robot-assisted thoracic surgery (RATS) and video-assisted thoracic surgery (VATS) for non-small cell lung cancer (NSCLC). Methods Online databases including PubMed, EMbase, Web of Science, The Cochrane Library, CNKI, Wanfang, VIP and CBM from inception to 18 February, 2022 were searched by two researchers independently. The references of related studies were also searched to re-enroll the potential studies. The quality of the studies was evaluated with Newcastle-Ottawa Scale (NOS). The meta-analysis was performed by RevMan 5.3. Results A total of 43 studies including 33 089 patients were enrolled in the final study. The NOS scores of the included studies were ≥6 points. The results of meta-analysis showed that the operation time was longer [MD=8.50, 95%CI (1.59, 15.41), P=0.020], the blood loss was less [MD=−46.58, 95%CI (−62.86, −30.29), P<0.001], the dissected lymph nodes stations were more [MD=0.67, 95%CI (0.40, 0.93), P<0.001], the dissected lymph nodes were more [MD=2.39, 95%CI (1.43, 3.36), P<0.001], the conversion rate was lower [OR=0.52, 95%CI (0.46, 0.59), P<0.001], the time of chest tube drainage was shorter [MD=−0.35, 95%CI (−0.58, −0.11), P=0.004], the length of hospital stay was shorter [MD=−0.32, 95%CI (−0.45, −0.19), P<0.001], and the recurrence rate was lower [OR=0.51, 95%CI (0.36, 0.72), P<0.001] in the RATS group than those in the VATS group. The rate of overall postoperative complications [OR=0.95, 95%CI (0.89, 1.01), P=0.110] and postoperative mortality rate [OR=0.85, 95%CI (0.62, 1.16), P=0.300] were not significantly different between the two groups. Conclusion Compared with VATS, although RATS prolongs the operation time, it does not increase the incidence of postoperative complications and mortality rates. Moreover, RATS can dissect more lymph nodes, effectively control intraoperative bleeding, shorten the duration of chest drainage tube indwelling and shorten the postoperative hospital stay to a certain extent.
