Perioperative outcomes of robotic surgery for the treatment of lung cancer compared to a conventional video-assisted thoracoscopic surgery (VATS) technique

摘要

// Zipu Yu 1, * , Qiong Xie 2, * , Lei Guo 2 , Xin Chen 2 , Chenyao Ni 2 , Wenzong Luo 2 , Weidong Li 2 and Liang Ma 2 1 Department of Thoracic Surgery, 2nd Affiliated Hospital, Zhejiang University, Hangzhou, China 2 Department of Cardiothoracic Surgery, 1st Affiliated Hospital, Zhejiang University, Hangzhou, China * These authors contributed equally to this work Correspondence to: Liang Ma, email: [email protected] Weidong Li, email: [email protected] Keywords: robotic, video-assisted thoracoscopic surgery, lung cancer, da Vinci robotic system, meta-analysis Received: January 16, 2016      Accepted: July 11, 2017      Published: July 25, 2017 ABSTRACT Aim: To conduct a meta-analysis to determine the relative merits between robotic video-assisted thoracoscopic surgery (R-VATS) and conventional video-assisted thoracoscopic surgery (VATS) for lung cancer. Results: Fifteen studies matched the selection criterion, which reported 8827 subjects, of whom 1704 underwent R-VATS and 7123 underwent VATS. Compared the perioperative outcomes with VATS, reports of R-VATS indicated unfavorable outcomes considering the operative time (SMD = 0.48, 95% CI 0.15 to 0.81). Meanwhile, the number of dissected lymph nodes (SMD = 0.12, 95% CI −0.27 to 0.51) and hospital stay following surgery (SMD = −0.1; 95% CI −0.27 to 0.07), conversion (RR = 0.68; 95% CI 0.42 to 1.11), morbidity (RR = 0.99, 95% CI 0.92 to 1.07) and mortality (RR = 0.33, 95% CI 0.1 to 1.09) were similar for both procedures. Materials and Methods: A literature search was performed to identify comparative studies reporting perioperative outcomes for R-VATS and VATS for lung cancer. Pooled risk ratio (RR) and standardized mean differences (SMDs) with 95% confidence intervals (95% CIs) were calculated using either the fixed effects model or the random effects model. Conclusions: There is no difference in terms of perioperative outcomes between R-VATS and VATS except for the operative time which is significantly high for R-VATS. Further studies are required to confirm these results.