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Meta-Analysis
. 2021 Feb;199(1):43-53.
doi: 10.1007/s00408-020-00411-9. Epub 2021 Jan 2.

Uniportal Versus Multiportal Video-Assisted Thoracoscopic Lobectomy for Lung Cancer: An Updated Meta-analysis

Dimitrios E Magouliotis  1   2   3 , Maria P Fergadi  4 , Kyriakos Spiliopoulos  5 , Kalliopi Athanassiadi  6
Affiliations
Meta-Analysis

Uniportal Versus Multiportal Video-Assisted Thoracoscopic Lobectomy for Lung Cancer: An Updated Meta-analysis

Dimitrios E Magouliotis et al. Lung. 2021 Feb.

Erratum in

Abstract

Objective: We reviewed the available literature on patients with lung cancer undergoing either uniportal (UVATS) or multiport video-assisted thoracoscopic surgery (MVATS).

Methods: Original research studies that evaluated perioperative and long-term outcomes of UVATS versus MVATS were identified, from January 1990 to April 2020. The perioperative, along with the oncologic and long-term survival outcomes, were calculated according to either a fixed or a random effect model, appropriately. The Q statistics and I2 statistic were used to test for heterogeneity among the studies.

Results: Twenty studies were included, incorporating a total of 1,469 patients treated with UVATS and 3,231 treated with MVATS. The incidence of complications was lower in patients treated with UVATS [OR: 0.76 (95% CI 0.62, 0.93); p = 0.008]. The chest tube duration was significantly lower in the UVATS group (WMD: - 0.63 [95% CI - 1.03, - 0.23]; p = 0.002). Length of hospital stay (L.O.S.) was also lower in the UVATS patient group (WMD: - 0.54 [- 0.94, - 0.13]; p = 0.009), along with postoperative pain [WMD: - 0.57 (95% CI - 0.97, - 0.18); p = 0.004]. No significant differences were found regarding the mean operative time (M.O.T.), mean blood loss, the number of resected lymph nodes, the 30-day mortality, along with the survival at 1 and 3 years postoperatively.

Conclusions: The present meta-analysis indicates that UVATS is associated with enhanced outcomes in patients undergoing surgery for lung cancer. Well-designed, randomized studies, comparing UVATS to MVATS, are necessary to further assess their long-term clinical outcomes.

Keywords: Lung cancer; Single incision; Uniportal; Uvats; Vats; Video-assisted thoracoscopic surgery.

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Conflict of interest statement

Drs. DE Magouliotis, MP Fergadi, K Spiliopoulos, and K Athanassiadi have no conflicts of interest or financial ties to disclose.

Figures

Fig. 1
Fig. 1
UVATS versus MVATS for lung cancer flow diagram
Fig. 2
Fig. 2
Forest plots describing the differences in a chest tube duration, b length of stay (L.O.S.). a Chest tube duration was shorter in the UVATS group. b L.O.S. was shorter in the UVATS group. IV inverse variance statistical method; 95% CI 95% Confidence intervals
Fig. 3
Fig. 3
Forest plot describing the differences in total complications, along with subgroup analysis regarding arrhythmias and respiratory complications. Total complications were fewer in the UVATS group. No significant difference was found regarding the rate of arrhythmias and respiratory complications between the two groups. M-H Mantel–Haenszel statistical method; 95% CI 95% Confidence Interval
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