Perioperative outcomes of robotic surgery for the treatment of lung cancer compared to a conventional video-assisted thoracoscopic surgery (VATS) technique
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Zipu Yu1,*, Qiong Xie2,*, Lei Guo2, Xin Chen2, Chenyao Ni2, Wenzong Luo2, Weidong Li2 and Liang Ma2
1Department of Thoracic Surgery, 2nd Affiliated Hospital, Zhejiang University, Hangzhou, China
2Department of Cardiothoracic Surgery, 1st Affiliated Hospital, Zhejiang University, Hangzhou, China
*These authors contributed equally to this work
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
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.
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