Video-assisted Thoracoscope versus Thoracotomy Surgery for Non-small Cell Lung Cancer: A Systematic Review and Meta-analysis of Randomized Controlled Trials_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

ZHANGHao ,  QIHai , WANGLei , LIYuan-ming , CHENJia-hua , HEFeng-xiao

Department of Cardiothoracic Surgery, Te Second Afliated Hospital of Xinjiang Medical University, Urumqi 830063, P. R. China;

Corresponding?author：

QIHai, Email: cxju_qh@126.com

Keywords：

Lung cancer; Video-assisted thoracoscopic surgery; Thoracotomy; Meta-analysis; Systematic review

DOI：

10.7507/1007-4848.20150273

Video：

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Objective To evaluated the effect of the video-assisted thoracoscope surgery(VATS) for non-small cell lung cancer. Methods We searched EMbase, PubMed, OVID, Springer Link, Cochrane Library, CNKI, CBMdisc, and VIP to collect randomized controlled trials(RCTs) of VATS versus thoracotomy for non-small cell lung cancer. Each database was searched from establishment to October 2014. Two reviewers independently assessed the quality of the included studies and extracted relevant data, using RevMan5.3 meta-analysis software. Results We finally identified 10 RCTs involving 1 529 patients. There were 453 patients in the VATS group and 1 076 patients in the thoracotomy group. The results of meta-analysis showed that there was no statistical difference in the number of lymph node dissection(P=0.41), operation time(P=0.14), operation bleeding volume(P=0.14), chest tube placement time(P=0.53), operation mortality(P=0.72), and the overall survival rate(P=0.39). While there were statistical differences in thoracic drainage(P=0.04), post-operation hospital stay(P=0.01), and postoperative complications(P=0.0001). Conclusion VATS is safe and effective in the treatment of non-small cell lung cancer.

Citation： ZHANGHao, QIHai, WANGLei, LIYuan-ming, CHENJia-hua, HEFeng-xiao. Video-assisted Thoracoscope versus Thoracotomy Surgery for Non-small Cell Lung Cancer: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2015, 22(12): 1087-1094. doi: 10.7507/1007-4848.20150273 Copy

1.	Lewis RJ, Caccavale RJ, Sisler GE, et al. Video-assisted thoracic surgical resection of malignant lung tumor. J Thorac Cardiovasc Surg, 1992, 104(6):1679-1685.
2.	Mckenna RJ Jr. Lobectomy with mediastinal lymph onde sampling or issection. Chest Surg Clin Am, 2005, 4(12):233-236.
3.	Swanson SJ, Herndon JE 2nd, D'Amico TA, et al. Video-assisted thoracic surgery lobectomy:report of CALGB 39802——a prospective, multi-institution feasibility study. J Clin Oncol, 2007, 25(31):4993-4997.
4.	Chen FF, Zhang D, Wang YL, et al. Video-assisted thoracoscopic surgery lobectomy versus open lobectomy in patients with clinical stage I non-small cell lung cancer:a meta-analysis. Eur J Surg Oncol, 2013, 39(9):957-963.
5.	Taioli E, Lee DS, Lesser M, et al. Long-term survival in video-assisted thoracoscopic lobectomy vs open lobectomy in lung-cancer patients: a meta-analysis. Eur J Cardiothorac Surg, 2013, 44(4):591-597.
6.	Cao C, Manganas C, Ang SC, et al. A meta-analysis of unmatched and matched patients comparing video-assisted thoracoscopic lobectomy and conventional open lobectomy. Ann Cardiothorac Surg, 2012, 1(1):16-23.
7.	Li Z, Liu H, Li L. Video-assisted thoracoscopic surgery versus open lobectomy for stage I lung cancer:A meta-analysis of long-term outcomes. Exp Ther Med, 2012, 3(5):886-892.
8.	Cai YX, Fu XN, Xu QZ, et al. Thoracoscopic lobectomy versus open lobectomy in stage I non-small cell lung cancer:a meta-analysis. PLoS One, 2013, 8(12):e82366.
9.	Whitson BA, Groth SS, Duval SJ, et al. Surgery for early-stage nonsmall cell lung cancer:a systematic review of the video-assisted thoracoscopic surgery versus thoracotomy approaches to lobectomy. Ann Thorac Surg, 2008, 86(6):2008-2018.
10.	Cheng D, Downey RJ, Kernstine K, et al. Video-assisted thoracic surgery in lung cancer resection:a meta-analysis and systematic review of controlled trials. Innovations (Phila), 2007, 2(6):261-292.
11.	支修益, 吳一龍, 馬勝林, 等.原發性肺癌診療規范(2011年版). 中國肺癌雜志, 2012, 15(12):677-688.
12.	鄭明華. 主編. Meta分析軟件應用與實例解析. 第1版. 北京:人民衛生出版社, 2013. 71-72.
13.	Kirby TJ, Mack MJ, Landreneau RJ, et al. Lobectomy——video-assisted thoracic surgery versus muscle-sparing thoracotomy. a randomized trial. J Thorac Cardiovasc Surg, 1995, 109(5):997-1001.
14.	Sugi K, Kaneda Y, Esato K. Video-assisted thoracoscopic lobectomy achieves a satisfactory long-term prognosis in patients with clinical stage IA lung cancer. World J Surg, 2000, 24(1):27-31.
15.	Yim AP, Wan S, Lee TW, et al. VATS lobectomy reduces cytokine responses compared with conventional surgery. Ann Thorac Surg, 2000, 70(1):243-247.
16.	Craig SR, Leaver HA, Yap PL, et al. Acute phase responses following minimal access and conventional thoracic surgery. Eur J Cardiothorac Surg, 2001, 20(3):455-463.
17.	龍浩, 林志潮, 司徒冬榮. 電視輔助胸腔鏡與小切口開胸肺切除術所致損傷的對照研究. 中華外科雜志, 2008, 46(6):401-404.
18.	Scott WJ, Allen MS, Darling G, et al. Video-assisted thoracic surgery versus open lobectomy for lung cancer:a secondary analysis of data from the American College of Surgeons Oncology Group Z0030 randomized clinical trial. J Thorac Cardiovasc Surg, 2010, 139(4):976-983.
19.	張軼, 姜格寧, 王群, 等. 早期非小細胞肺癌胸腔鏡與開胸肺葉切除術后細胞因子變化的隨機對照研究. 中華外科雜志, 2010, 48(17):1285-1288.
20.	龍浩, 鄭燕, 林勇斌, 等. 電視胸腔鏡與小切口開胸治療臨床早期非小細胞肺癌患者術后生活質量的前瞻性隨機對照研究. 中國胸心血管外科臨床雜志, 2012, 19(2):130-135.
21.	Palade E, Passlick B, Osei-Agyemang T, et al. Video-assisted vs open mediastinal lymphadenectomy for stage I non-small-cell lung cancer:results of a prospective randomized trial. Eur J Cardiothorac Surg, 2013, 44(2):244-249.
22.	曾劍, 劉金石. 胸腔鏡輔助肺癌切除術后生活質量的研究. 中國肺癌雜志, 2014, 17(3):209-214.
23.	Lewis RJ, Caccavale RJ, Sisler GE, et al. One hundred consecutive patients undergoing video-assisted thoracic operations. Ann Thorac Surg, 1992, 54(3):421-426.
24.	McKenna RJ Jr. Lobectomy by video-assisted thoracic surgery with mediastinal node sampilng for lung cancer. J Thorac Cardiovasc Surg, 1994, 107(3):879-882.
25.	劉漢云, 張自正, 梁錦崧, 等. 單向式胸腔鏡肺葉切除術在周圍型肺癌手術中的應用. 中華臨床醫師雜志(電子版), 2011, 5(22):6826-6827.
26.	Sagawa M, Sato M, Sakurada A, et al. A prospective trial of systematic nodal dissection for lung cancer by video-assisted thoracic surgery:can it be perfect? Ann Thorac Surg, 2002, 73(3):900-904.
27.	何建行, 楊運有, 霍文遜, 等. 胸腔鏡輔助胸腔淋巴結清掃術. 廣東醫學, 2000, 21(10):828-830.
28.	Jiang G, Yang F, Li X, et al. Video-assisted thoracoscopic surgery is more favorable than thoracotomy for administration of adjuvant chemotherapy after lobectomy for non-small cell lung cancer. World J Surg Oncol, 2011, 9(2):170.
29.	Papiashvilli M, Stav D, Cyjon A, et al. Lobectomy for non-small cell lung cancer:differences in morbidity and mortality between thoracotomy and thoracoscopy. Innovations(Phila), 2012, 7(1):15-22.
30.	陳海泉. 胸腔鏡下非小細胞肺癌的外科治療:一項原則和兩個基本點. 醫學與哲學(臨床決策論壇版), 2011, 32(9):9-10.

1. Lewis RJ, Caccavale RJ, Sisler GE, et al. Video-assisted thoracic surgical resection of malignant lung tumor. J Thorac Cardiovasc Surg, 1992, 104(6):1679-1685.
2. Mckenna RJ Jr. Lobectomy with mediastinal lymph onde sampling or issection. Chest Surg Clin Am, 2005, 4(12):233-236.
3. Swanson SJ, Herndon JE 2nd, D'Amico TA, et al. Video-assisted thoracic surgery lobectomy:report of CALGB 39802——a prospective, multi-institution feasibility study. J Clin Oncol, 2007, 25(31):4993-4997.
4. Chen FF, Zhang D, Wang YL, et al. Video-assisted thoracoscopic surgery lobectomy versus open lobectomy in patients with clinical stage I non-small cell lung cancer:a meta-analysis. Eur J Surg Oncol, 2013, 39(9):957-963.
5. Taioli E, Lee DS, Lesser M, et al. Long-term survival in video-assisted thoracoscopic lobectomy vs open lobectomy in lung-cancer patients: a meta-analysis. Eur J Cardiothorac Surg, 2013, 44(4):591-597.
6. Cao C, Manganas C, Ang SC, et al. A meta-analysis of unmatched and matched patients comparing video-assisted thoracoscopic lobectomy and conventional open lobectomy. Ann Cardiothorac Surg, 2012, 1(1):16-23.
7. Li Z, Liu H, Li L. Video-assisted thoracoscopic surgery versus open lobectomy for stage I lung cancer:A meta-analysis of long-term outcomes. Exp Ther Med, 2012, 3(5):886-892.
8. Cai YX, Fu XN, Xu QZ, et al. Thoracoscopic lobectomy versus open lobectomy in stage I non-small cell lung cancer:a meta-analysis. PLoS One, 2013, 8(12):e82366.
9. Whitson BA, Groth SS, Duval SJ, et al. Surgery for early-stage nonsmall cell lung cancer:a systematic review of the video-assisted thoracoscopic surgery versus thoracotomy approaches to lobectomy. Ann Thorac Surg, 2008, 86(6):2008-2018.
10. Cheng D, Downey RJ, Kernstine K, et al. Video-assisted thoracic surgery in lung cancer resection:a meta-analysis and systematic review of controlled trials. Innovations (Phila), 2007, 2(6):261-292.
11. 支修益, 吳一龍, 馬勝林, 等.原發性肺癌診療規范(2011年版). 中國肺癌雜志, 2012, 15(12):677-688.
12. 鄭明華. 主編. Meta分析軟件應用與實例解析. 第1版. 北京:人民衛生出版社, 2013. 71-72.
13. Kirby TJ, Mack MJ, Landreneau RJ, et al. Lobectomy——video-assisted thoracic surgery versus muscle-sparing thoracotomy. a randomized trial. J Thorac Cardiovasc Surg, 1995, 109(5):997-1001.
14. Sugi K, Kaneda Y, Esato K. Video-assisted thoracoscopic lobectomy achieves a satisfactory long-term prognosis in patients with clinical stage IA lung cancer. World J Surg, 2000, 24(1):27-31.
15. Yim AP, Wan S, Lee TW, et al. VATS lobectomy reduces cytokine responses compared with conventional surgery. Ann Thorac Surg, 2000, 70(1):243-247.
16. Craig SR, Leaver HA, Yap PL, et al. Acute phase responses following minimal access and conventional thoracic surgery. Eur J Cardiothorac Surg, 2001, 20(3):455-463.
17. 龍浩, 林志潮, 司徒冬榮. 電視輔助胸腔鏡與小切口開胸肺切除術所致損傷的對照研究. 中華外科雜志, 2008, 46(6):401-404.
18. Scott WJ, Allen MS, Darling G, et al. Video-assisted thoracic surgery versus open lobectomy for lung cancer:a secondary analysis of data from the American College of Surgeons Oncology Group Z0030 randomized clinical trial. J Thorac Cardiovasc Surg, 2010, 139(4):976-983.
19. 張軼, 姜格寧, 王群, 等. 早期非小細胞肺癌胸腔鏡與開胸肺葉切除術后細胞因子變化的隨機對照研究. 中華外科雜志, 2010, 48(17):1285-1288.
20. 龍浩, 鄭燕, 林勇斌, 等. 電視胸腔鏡與小切口開胸治療臨床早期非小細胞肺癌患者術后生活質量的前瞻性隨機對照研究. 中國胸心血管外科臨床雜志, 2012, 19(2):130-135.
21. Palade E, Passlick B, Osei-Agyemang T, et al. Video-assisted vs open mediastinal lymphadenectomy for stage I non-small-cell lung cancer:results of a prospective randomized trial. Eur J Cardiothorac Surg, 2013, 44(2):244-249.
22. 曾劍, 劉金石. 胸腔鏡輔助肺癌切除術后生活質量的研究. 中國肺癌雜志, 2014, 17(3):209-214.
23. Lewis RJ, Caccavale RJ, Sisler GE, et al. One hundred consecutive patients undergoing video-assisted thoracic operations. Ann Thorac Surg, 1992, 54(3):421-426.
24. McKenna RJ Jr. Lobectomy by video-assisted thoracic surgery with mediastinal node sampilng for lung cancer. J Thorac Cardiovasc Surg, 1994, 107(3):879-882.
25. 劉漢云, 張自正, 梁錦崧, 等. 單向式胸腔鏡肺葉切除術在周圍型肺癌手術中的應用. 中華臨床醫師雜志(電子版), 2011, 5(22):6826-6827.
26. Sagawa M, Sato M, Sakurada A, et al. A prospective trial of systematic nodal dissection for lung cancer by video-assisted thoracic surgery:can it be perfect? Ann Thorac Surg, 2002, 73(3):900-904.
27. 何建行, 楊運有, 霍文遜, 等. 胸腔鏡輔助胸腔淋巴結清掃術. 廣東醫學, 2000, 21(10):828-830.
28. Jiang G, Yang F, Li X, et al. Video-assisted thoracoscopic surgery is more favorable than thoracotomy for administration of adjuvant chemotherapy after lobectomy for non-small cell lung cancer. World J Surg Oncol, 2011, 9(2):170.
29. Papiashvilli M, Stav D, Cyjon A, et al. Lobectomy for non-small cell lung cancer:differences in morbidity and mortality between thoracotomy and thoracoscopy. Innovations(Phila), 2012, 7(1):15-22.
30. 陳海泉. 胸腔鏡下非小細胞肺癌的外科治療:一項原則和兩個基本點. 醫學與哲學(臨床決策論壇版), 2011, 32(9):9-10.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Video-assisted Thoracoscope versus Thoracotomy Surgery for Non-small Cell Lung Cancer: A Systematic Review and Meta-analysis of Randomized Controlled Trials

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