Uniport versus multiport video-assisted thoracoscopic surgery in the perioperative treatment of patients with T1–3N0M0 non-small cell lung cancer: a systematic review and meta-analysis

Yang, Xinyu; Li, Ming; Yang, Xiaodong; Zhao, Mengnan; Huang, Yiwei; Dai, Xiaoming; Jiang, Tian; Feng, Mingxiang; Zhan, Cheng; Wang, Qun

doi:10.21037/jtd.2018.03.74

Cited by 29 publications

(29 citation statements)

References 21 publications

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“…Recently, several meta-analyses had compared the perioperative outcomes of U-VATS and M-VATS [32][33][34][35][36][37]. Some of the previous meta-analyses elucidated better perioperative outcomes on U-VATS.…”

Section: Discussionmentioning

confidence: 99%

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Uniportal versus multiportal video-assisted thoracoscopic anatomical resection for NSCLC: a meta-analysis

Yan

Han

Zhang

et al. 2020

J Cardiothorac Surg

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Background Uniportal video-assisted thoracoscopic surgery (U-VATS) has recently emerged as an alternative procedure for non-small cell lung cancer (NSCLC); however, whether U-VATS has advantages over multiportal VATS (M-VATS) remains unknown. Methods We performed a systematic review of two databases (Pubmed and Web of Science) to search comparative studies of U-VATS and M-VATS anatomical pulmonary resection for NSCLC. Operative time, blood loss, number of resected lymph nodes, drainage duration, length of postoperative stay, pain in postoperative day 1(POD1) and conversion rates were retrieved to estimate the comparison of outcomes. A subgroup analysis stratified by study type (propensity-matched analysis and randomized-controlled trial versus non-propensity matched analysis) was performed. Result A total of 20 studies with 4142 patients were included in this meta-analysis. U-VATS was performed on 1869 patients, whereas the other 2173 patients underwent M-VATS. This meta-analysis showed that there was no significant difference in operative time (U-VATS: 146.48 ± 55.07 min versus M-VATS: 171.70 ± 79.40 min, P = 0.81), blood loss (74.49 ± 109.03 mL versus 95.48 ± 133.67 mL, P = 0.18), resected lymph nodes (17.28 ± 9.46 versus 18.31 ± 10.17, P = 0.62), conversion rate (6.18% versus 4.34%, P = 0.14), drainage duration (3.90 ± 2.94 days versus 4.44 ± 3.12 days, p = 0.09), length of postoperative stay (6.16 ± 4.40 days versus 6.45 ± 4.80 days, P = 0.22), and pain in POD1 (3.94 ± 1.68 versus 3.59 ± 2.76, p = 0.07). Subgroup analysis showed the value of PSM and RCT group consistency with overall value. Conclusion This up-to-date meta-analysis shows that the perioperative outcomes of U-VATS and M-VATS anatomical pulmonary resection are equivalent. In addition, the differences in long-term outcomes of these two approaches are still unclear. Thoracic surgeons should pay more emphasize on providing high-quality and personalized surgical care for patients, to improve the survival ultimately.

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Section: Discussionmentioning

confidence: 99%

“…For instance, Yang X.Y. et al reported that patients in U-VATS group had a significant reduction with regard to blood loss, length of stay, and pain in POD1 compared with patients undergoing M-VATS approach [32]. Yang Z. et al reported that U-VATS approach significantly reduced length of hospital stay against M-VATS approach [37].…”

Section: Discussionmentioning

confidence: 99%

Uniportal versus multiportal video-assisted thoracoscopic anatomical resection for NSCLC: a meta-analysis

Yan

Han

Zhang

et al. 2020

J Cardiothorac Surg

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show abstract

“…Recently, several meta-analyses had compared the perioperative outcomes of U-VATS and M-VATS. [32][33][34][35][36][37] Some of the previous meta-analyses elucidated better perioperative outcomes on U-VATS. For instance, Yang X.Y.…”

Section: Discussionmentioning

confidence: 99%

“…et al reported that patients in U-VATS group had a signi cant reduction with regard to blood loss , length of stay, and pain in POD1 compared with patients undergoing M-VATS approach. [32] Yang Z. et al reported that U-VATS approach signi cantly reduced length of hospital stay against M-VATS approach. [37] By contrast, our meta-analysis demonstrated that there was no signi cant difference between U-VATS and M-VATS approach on these results, which showed that U-VATS approach has limited advantage over M-VATS in perioperative outcomes.…”

Section: Discussionmentioning

confidence: 99%

Uniportal versus multiportal video-assisted thoracoscopic anatomical resection for NSCLC: a meta-analysis

Yan

Han

Zhang

et al. 2020

Preprint

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Background Uniportal video-assisted thoracoscopic surgery (U-VATS) has recently emerged as an alternative procedure for non-small cell lung cancer (NSCLC); however, whether U-VATS has advantages over multiportal VATS (M-VATS) remains unknown. Methods We performed a systematic review of two databases (Pubmed and Web of Science) to search comparative studies of U-VATS and M-VATS anatomical pulmonary resection for NSCLC. Parameters of continuous variables (operative time, blood loss, number of resected lymph nodes, drainage duration, length of postoperative stay and pain in postoperative day 1(POD1)) or categorical variables (conversion rates) were retrieved to estimate the comparitiveoutcomes. A subgroup analysis stratified by study type (propensity-matched analysis& randomized-controlled trial versus non-propensity matched analysis) was performed. Result A total of 19 studies with 3809 patients were included in this meta-analysis. U-VATS was performed on 1747 patients, whereas the other 2062 patients underwent M-VATS. This meta-analysis showed that there was no significant difference in operative time (U-VATS: 146.48±55.07min versus M-VATS: 171.70±79.40min, P=0.81), blood loss (74.49±109.03mL versus 95.48±133.67mL, P=0.18), resected lymph nodes (17.28±9.46 versus 18.31±10.17, P=0.62), conversion rate (6.18% versus 4.34%, P=0.14), drainage duration (3.90±2.94 days versus 4.44±3.12 days, p=0.09), length of postoperative stay (6.16±4.40 days versus 6.45±4.80 days, P=0.22), and pain in POD1 (3.94±1.68 versus 3.59±2.76, p=0.07). Subgroup analysis showed the value of PSM&RCT group consistency with overall value. Conclusion This up-to-date meta-analysis shows that the perioperative outcomes of U-VATS and M-VATS anatomical pulmonary resection are equivalent. In addition, the differences in long-term outcomes of these two approaches are still unclear. Thoracic surgeons should pay more emphasize on providing high-quality and personalized surgical care for patients, to improve the survival ultimately.

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“…Lung cancer is the most frequently occurring human cancer and is the leading cause of cancer-associated mortality among males, followed by prostate and colorectal cancer for incidence, and liver and stomach cancer for mortality (6). Currently, although clinical therapeutic methods, including radiotherapy, chemotherapy, Chinese medicinal herb treatment, immunotherapy, gene therapy and targeted therapy, have been investigated and applied for the treatment of patients with lung cancer (7)(8)(9)(10), the overall 5-year survival rate remains poor at <15% (11)(12)(13).…”

Section: Introductionmentioning

confidence: 99%

Role of Gd2O3‑doped carbon‑11‑choline‑lenvatinib nanoparticles contrast agent PET/CT in the diagnosis of patients with lung cancer

et al. 2019

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Positron emission tomography-computed tomography (PET/CT) is an efficient method for the diagnosis of various types of human cancer. Studies have demonstrated that Gd 2 O 3-doped carbon-11-choline (GdCho) can be used as a contrast nanoparticle for PET/CT in the diagnosis of patients with lung cancer. The aim of the present study was to evaluate the effect of GdCho-lenvatinib nanoparticles contrast-PET/CT (GdCho-Len-PET) in the diagnosis and treatment planning of a cohort of patients suspected of having lung cancer. The results of the present study demonstrated that GdCho-Len could be used as an efficient PET/CT contrast agent for the diagnosis of patients with lung cancer. GdCho-Len nanoparticles contrast agent exhibited a significantly improved longitudinal relaxivity compared with GdCho. The outcomes of the present study were that GdCho-Len-PET diagnosed 152 patients with lung cancer, whereas GdCho-PET diagnosed 130 patients with lung cancer among the 172 patients. GdCho-Len-PET presented with higher accuracy and sensitivity compared with GdCho-PET in diagnosing patients with lung cancer. All patients were further confirmed via histological analysis. GdCho-Len-PET contributed to the anticancer treatments in 56 out of 62 (90.3%) patients with lung cancer who were candidates for radiation therapy, 52 out of 57 (91.2%) patients with lung cancer undergoing adjuvant radiotherapy, and 13 out of 17 (76.5%) patients with lung cancer undergoing comprehensive therapy. Patients diagnosed using GdCho-Len-PET improved the survival of patients with lung cancer during a 420-day follow up. In conclusion, GdCho-Len-PET increased the diagnostic efficacy and had a significant effect on survival for patients with lung cancer, and may therefore serve as a reliable method for human cancer diagnosis.

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Uniport versus multiport video-assisted thoracoscopic surgery in the perioperative treatment of patients with T1–3N0M0 non-small cell lung cancer: a systematic review and meta-analysis

Cited by 29 publications

References 21 publications

Uniportal versus multiportal video-assisted thoracoscopic anatomical resection for NSCLC: a meta-analysis

Uniportal versus multiportal video-assisted thoracoscopic anatomical resection for NSCLC: a meta-analysis

Uniportal versus multiportal video-assisted thoracoscopic anatomical resection for NSCLC: a meta-analysis

Role of Gd2O3‑doped carbon‑11‑choline‑lenvatinib nanoparticles contrast agent PET/CT in the diagnosis of patients with lung cancer

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