Feasibility and oncological outcomes of video‐assisted thoracic surgery versus thoracotomy for pathologic <scp>N2</scp> disease in non–small cell lung cancer: A comprehensive systematic review and meta‐analysis

Li, Yong; Huang, Kaili; Deng, Han‐Yu; Zheng, Qiangqiang; Xiao, Tao; Yu, Jinming; Zhou, Qinghua

doi:10.1111/1759-7714.14614

Cited by 4 publications

(6 citation statements)

References 44 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…VATS is a thoracic surgical technique that is less invasive, less painful, and has a faster recovery than the traditional sternotomy, and has become the preferred treatment for non‐small cell lung cancer 7 . Most recent clinical studies have reported that VATS for early‐stage lung cancer can shorten operative time, reduce intraoperative bleeding and perioperative pain, and reduce inflammation and complications, with significant clinical efficacy compared with traditional open‐heart surgery 8‐12 . There are many clinical reports on VATS for lung cancer; however, while surgical site wound infections are among the most common postoperative complications in patients undergoing surgery, there are few studies on the effects of VATS on postoperative wound infection and wound pain in patients with lung cancer.…”

Section: Introductionmentioning

confidence: 99%

“…7 Most recent clinical studies have reported that VATS for early-stage lung cancer can shorten operative time, reduce intraoperative bleeding and perioperative pain, and reduce inflammation and complications, with significant clinical efficacy compared with traditional open-heart surgery. [8][9][10][11][12] There are many clinical reports on VATS for lung cancer; however, while surgical site wound infections are among the most common postoperative complications in patients undergoing surgery, there are few studies on the effects of VATS on postoperative wound infection and wound pain in patients with lung cancer. The aim of this study was to investigate the effect of VATS on surgical site wound infection and wound pain in patients with lung cancer, with the hope of facilitating evidence-based decision-making for optimal surgical outcomes.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Surgical site wound infection and wound pain after video‐assisted thoracoscopy in patients with lung cancer: A meta‐analysis

Zhou

Ren

Gao

et al. 2023

International Wound Journal

View full text Add to dashboard Cite

A meta‐analysis was performed to comprehensively assess the effects of video‐assisted thoracoscopy on surgical site wound infection and wound pain in patients with lung cancer. Studies on video‐assisted thoracoscopy for lung cancer were collected from PubMed, EMBASE, Cochrane Library, Web of Science, China National Knowledge Infrastructure, Chinese Biomedical Literature Database, and Wanfang database, from inception to January 2023. Two researchers independently screened the literature, extracted the data, and evaluated the quality of the included studies according to the inclusion and exclusion criteria. Meta‐analysis was performed using RevMan 5.4 software. Thirty‐one articles with a total of 3608 patients were included, with 1809 in the video‐assisted thoracoscopy group and 1799 in the control group. Compared with the control group, video‐assisted thoracoscopy significantly reduced surgical site wound infection (odds ratio: 0.22, 95% confidence interval [CI]: 0.14–0.33, P < .001) and surgical site wound pain at postoperative day 1 (standardised mean difference [SMD]: −0.90, 95% CI: −1.17 to −0.64, P < .001) and postoperative day 3 (SMD: −1.59, 95% CI: −2.25 to −0.92, P < .001). Thus, these results showed that video‐assisted thoracoscopy may have beneficial outcomes by reducing surgical site wound infection and pain. However, owing to the large variation in sample sizes and some methodological shortcomings, further validation is needed in future studies with higher quality and larger sample sizes.

show abstract

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Surgical site wound infection and wound pain after video‐assisted thoracoscopy in patients with lung cancer: A meta‐analysis

Zhou

Ren

Gao

et al. 2023

International Wound Journal

View full text Add to dashboard Cite

show abstract

“…Compared with the thoracotomy, thoracoscopic has a lot of benefits in terms of less complications after operation and shorter stay in the hospital 18–20 . Furthermore, it can decrease surgical time and decrease haemorrhage during operation than conventional thoracotomy for early stage lung cancer 21–25 . The purpose of this research is to evaluate the efficacy of thoracoscopic surgery in comparison with that of thoracotomy.…”

Section: Introductionmentioning

confidence: 99%

“…[18][19][20] Furthermore, it can decrease surgical time and decrease haemorrhage during operation than conventional thoracotomy for early stage lung cancer. [21][22][23][24][25] The purpose of this research is to evaluate the efficacy of thoracoscopic surgery in comparison with that of thoracotomy.…”

Section: Introductionmentioning

confidence: 99%

Effect of thoracoscopic and thoracotomy on postoperative wound complications in patients with lung cancer: A meta‐analysis

Qiu,

Han,

Zhao

2023

International Wound Journal

View full text Add to dashboard Cite

Because of the difficult surgical procedures, patients with lung cancer who have received thoracic surgery tend to have postoperative complications. It may lead to postoperative complications like wound infection, wound haematoma and pneumothorax. A lot of research has assessed the effect of various surgery methods on postoperative complications in pulmonary cancer. The purpose of this meta‐analysis is to establish if thoracoscopic is superior to that of thoracotomy in the rate of post‐operative complications. From the beginning to the end of June 2023, we performed an exhaustive search on four main databases for key words. The Hazard of Bias in Non‐Randomized Interventional Studies (ROBINS‐I) was evaluated in the literature. In the end, 13 trials that fulfilled the eligibility criteria underwent further statistical analyses. The results showed that thoracoscopic intervention decreased the risk of post operative wound infection (dominant ratio [OR], 3.00; 95% confidence margin [CI], 1.98, 4.55; p < 0.00001) and air‐leakage after operation (OR, 1.30; 95% CI, 1.04, 1.63; p = 0.02). There was no statistically significant difference between the two groups in terms of the rate of haemorrhage after operation (OR, 0.10; 95% CI, 0.73, 1.66; p = 0.63). Our findings indicate that thoracoscopic is less likely to cause post operative infection and gas leakage than thoracotomy, and it does not decrease the risk of postoperative haemorrhage. As some of the chosen trials are too small to conduct meta‐analyses, care must be taken when handling the data. In the future, a large number of randomized, controlled trials will be required to provide additional evidence for this research.

show abstract

“…After neoadjuvant therapy for N2 NSCLC, the tumor and mediastinal nodal stations may appear inflamed and have dense adhesions, which increase the risk of surgery ( 30 , 31 ). Recently, a meta-analysis only analyzed the approach VATS and OT, which ignored the RATS approach ( 32 ). Therefore, we conducted a systematic review and meta-analysis to compare the effectiveness and safety of MIS and OT for N2 NSCLC.…”

Section: Introductionmentioning

confidence: 99%

Minimally invasive surgery vs. open thoracotomy for non-small-cell lung cancer with N2 disease: a systematic review and meta-analysis

Liu

Tang

et al. 2023

Front. Med.

View full text Add to dashboard Cite

BackgroundThis meta-analysis aimed to investigate the effectiveness and safety of minimally invasive surgery [MIS, including robotic-assisted thoracoscopic surgery (RATS) and video-assisted thoracoscopic surgery (VATS)] and open thoracotomy (OT) for non-small cell lung cancer (NSCLC) patients with N2 disease.MethodsWe searched online databases and studies from the creation of the database to August 2022, comparing the MIS group to the OT group for NSCLC with N2 disease. Study endpoints included intraoperative outcomes [e.g., conversion, estimated blood loss (EBL), surgery time (ST), total lymph nodes (TLN), and R0 resection], postoperative outcomes [e.g., length of stay (LOS) and complication], and survival outcomes [e.g., 30-day mortality, overall survival (OS), and disease-free survival (DFS)]. We estimated outcomes using random effects meta-analysis to account for studies with high heterogeneity (I2 > 50 or p < 0.05). Otherwise, we used a fixed-effect model. We calculated odds ratios (ORs) for binary outcomes and standard mean differences (SMDs) for continuous outcomes. Treatment effects on OS and DFS were described by hazard ratio (HR).ResultsThis systematic review and meta-analysis of 15 studies on MIS vs. OT for NSCLC with N2 disease included 8,374 patients. Compared to OT, patients that underwent MIS had less estimated blood loss (EBL) (SMD = – 64.82, p < 0.01), shorter length of stay (LOS) (SMD = −0.15, p < 0.01), higher R0 resection rate (OR = 1.22, p = 0.049), lower 30-day mortality (OR = 0.67, p = 0.03), and longer overall survival (OS) (HR = 0.61, P < 0.01). The results showed no statistically significant differences in surgical time (ST), total lymph nodes (TLN), complications, and disease-free survival (DFS) between the two groups.ConclusionCurrent data suggest that minimally invasive surgery may provide satisfying outcomes, a higher R0 resection rate, and better short-term and long-term survival than open thoracotomy.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/, identifier: CRD42022355712.

show abstract

Feasibility and oncological outcomes of video‐assisted thoracic surgery versus thoracotomy for pathologic N2 disease in non–small cell lung cancer: A comprehensive systematic review and meta‐analysis

Cited by 4 publications

References 44 publications

Surgical site wound infection and wound pain after video‐assisted thoracoscopy in patients with lung cancer: A meta‐analysis

Surgical site wound infection and wound pain after video‐assisted thoracoscopy in patients with lung cancer: A meta‐analysis

Effect of thoracoscopic and thoracotomy on postoperative wound complications in patients with lung cancer: A meta‐analysis

Minimally invasive surgery vs. open thoracotomy for non-small-cell lung cancer with N2 disease: a systematic review and meta-analysis

Contact Info

Product

Resources

About