Comparison of lymph node dissection of video-assisted thoracoscopic surgery and thoracotomy in the treatment of clinical stage Ⅰ lung cancer: a meta-analysis and system review / 中华胸心血管外科杂志

ABSTRACT

Objective To compare the efficacy of lymph nodes(LNs) dissection between video-assisted thoracic surgery (VATS) and thoracotomy in the treatment of clinical stage Ⅰ lung cancer.Methods A comprehensive search of PubMed,Ovid Medline,EMBASE,Web of Science,ScienceDirect,the Cochrane Library,Scopus database and Google Scholar was performed to identify studies comparing VATS and thoracotomy in LNs dissection.The data was analyzed by RevMan 5.3 software and SPSS 18.0.Results After selection,23 articles met the inclusion criteria.2 316 patients were involved in VATS group and 3 346 patients were involved in Open group.Meta analysis showed that less total LNs(95％ CI-1.64--0.60,P ＜ 0.0001),totalLNsstations(95％CI-0.61--0.01,P=0.04) andN1 LNs(95％CI-0.28--0.02,P=0.02)were dissected in VATS group.On the left side,more LNs were dissected in VATS group(95％ CI0.51-3.22,P =0.007).The same number of mediastinal LNs (95％ CI-0.74-0.15,P =0.20),mediastinal LNs stations (95％ CI-0.20-0.14,P =0.76),right side LNs (95 ％ CI-1.52-2.23,P =0.71) were harvested in both groups.Conclusion In the surgical treatment of clinical stage Ⅰ lung cancer,less total LNs,total LNs stations and N1 LNs were dissected in VATS group,while more left side LNs were harvested by VATS.The same number of mediastinal LNs,mediastinal LNs stations right side LNs were harvested in the two groups.This conclusion still needs to be further proved by more high-quality and large-scale RCTs.