Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2022 Nov 8;17(1):284.
doi: 10.1186/s13019-022-02034-y.

The perioperative outcomes of uniport versus two-port and three-port video-assisted thoracoscopic surgery in lung cancer: a systematic review and meta-analysis

Ya-Fu Cheng  1 , Chang-Lun Huang  1 , Wei-Heng Hung  1 , Ching-Yuan Cheng  1 , Bing-Yen Wang  2   3   4   5   6   7
Affiliations
Meta-Analysis

The perioperative outcomes of uniport versus two-port and three-port video-assisted thoracoscopic surgery in lung cancer: a systematic review and meta-analysis

Ya-Fu Cheng et al. J Cardiothorac Surg. .

Abstract

Background: Uniport video-assisted thoracoscopic surgery (VATS) has been applied widely for the treatment of lung cancer in recent years. Some studies have reported that uniport VATS might provide better outcomes than multiport VATS. However, the perioperative outcomes of uniport VATS compared with two-port and three-port VATS, respectively, have yet to be studied at a comprehensive scale. This meta-analysis study compares the perioperative efficacy among uniport, two-port, and three-port VATS.

Methods: We searched studies published before October 1, 2019, by using Web of Science databases, Ovid Medline, Embase, and PubMed. Studies that compared uniport VATS with two-port or three-port VATS for patients with lung cancer were included. Operative time, perioperative blood loss, number of lymph nodes retrieved, conversion rate, duration of postoperative chest tube drainage, length of hospital stay (LoS), visual analogue pain scores on postoperative day (POD) 1 and POD 3, and overall morbidity were evaluated.

Results: Sixteen studies that compared uniport VATS with two-port or three-port VATS in the treatment of lung cancer were included. Uniport VATS showed less blood loss, a shorter duration of postoperative drainage and a lower visual analogue pain score on POD 3 than two-port VATS; it showed a shorter duration of postoperative drainage, a shorter LoS, and lower visual analogue pain scores on POD 1 and POD 3 than three-port VATS. There were no significant differences in the number of lymph nodes retrieved, operative time, conversion rate, and overall morbidity rate when comparing uniport VATS with two-port VATS or three-port VATS.

Conclusions: Uniport VATS might provide better perioperative outcomes than either two-port or three-port VATS in lung cancer treatment.

Keywords: Non-small cell lung cancer; Single incision; Single port; Uniport; Video-assisted thoracoscopic surgery.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Flow diagram of the study selection process
Fig. 2
Fig. 2
Funnel plots for results included in the meta-analysis: A Blood loss of operation, B Visual analogue pain score on postoperative day 1
Fig. 3
Fig. 3
Forest plots for results: A Number of lymph nodes retrieved, B Operative time, C Conversion rate, D Morbidity rate
Fig. 4
Fig. 4
Forest plot of perioperative blood loss for uniport VATS, two-port VATS, and three-port VATS groups
Fig. 5
Fig. 5
Forest plots for results: A Duration of postoperative chest tube drainage, B length of hospital stay
Fig. 6
Fig. 6
Forest plots for results: A Visual analogue score of pain on postoperative day 1, B Visual analogue score of pain on postoperative day 3
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Henley SJ, Ward EM, Scott S, et al. Annual report to the nation on the status of cancer, part I: national cancer statistics. Cancer. 2020;126(10):2225–2249. doi: 10.1002/cncr.32802. - DOI - PMC - PubMed
    1. Landreneau RJ, Mack MJ, Hazelrigg SR, et al. Video-assisted thoracic surgery: basic technical concepts and intercostal approach strategies. Ann Thorac Surg. 1992;54(4):800–807. doi: 10.1016/0003-4975(92)91040-G. - DOI - PubMed
    1. Palade E, Guenter J, Kirschbaum A, et al. Postoperative pain in the acute phase after surgery: VATS lobectomy versus open lung resection: results of a prospective randomised trial. Zentralbl Chir. 2014;139(Suppl 1):S59–66. - PubMed
    1. Higuchi M, Yaginuma H, Yonechi A, et al. Long-term outcomes after video-assisted thoracic surgery (VATS) lobectomy versus lobectomy via open thoracotomy for clinical stage IA non-small cell lung cancer. J Cardiothorac Surg. 2014;9:88. doi: 10.1186/1749-8090-9-88. - DOI - PMC - PubMed
    1. Yamamoto H, Okada M, Takada M, et al. Video-assisted thoracic surgery through a single skin incision. Arch Surg. 1998;133(2):145–147. doi: 10.1001/archsurg.133.2.145. - DOI - PubMed