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One-port video-assisted thoracic surgery versus three-port video-assisted thoracic surgery for primary spontaneous pneumothorax: a meta-analysis

Abstract

Objective

To further understand the effects of video-assisted thoracic surgery (VATS) with one-port versus three-port VATS for primary spontaneous pneumothorax (PSP).

Methods

In this study, we searched information from the PubMed, Cochrane Library, Embase, ScienceDirect, Web of Science, China National Knowledge Infrastructure (CNKI), and Wanfang Data databases from inception to September 2015 to collect data of randomized controlled trials (RCTs) and cohort studies about one-port VATS versus three-port VATS for PSP. Two independent authors were committed to screen literature, extract data, and assess the risk of bias of related studies. Then, we used the RevMan 5.20 software for a meta-analysis of one-port VATS versus three-port VATS for PSP.

Results

Six cohort studies involving 310 patients were finally selected in this meta-analysis. The results of our study indicate that one-port VATS had a shorter hospital stay (SMD = −0.39, 95 % CI −0.69 to 0.09, P = 0.01), lower VAS score of 24-h post-operative pain (SMD = −0.78, 95 % CI −1.40 to −0.52, P < 0.00001), shorter chest drainage time (SMD = −0.68, 95 % CI −1.15 to −0.22, P = 0.004), and lower incidence of post-operative paraesthesia (OR = 0.13, 95 % CI 0.06 to 0.29, P < 0.00001) compared with three-port VATS. However, one-port VATS had a lower patient satisfaction score at 24 h (SMD = −0.65, 95 % CI −0.95 to −0.35, P < 0.0001) and 48 h (SMD = −0.46, 95 % CI −0.71 to −0.21, P = 0.0002). No differences in the recurrence of pneumothorax (OR = 0.58, 95 % CI 0.20 to 1.67, P = 0.32), the operation time (SMD = 1.01, 95 % CI −4.63 to 2.60, P = 0.58), and the satisfaction score at 72 h (SMD = −0.11, 95 % CI −0.44 to 0.22, P < 0.00001) were noted between the groups.

Conclusion

Current evidence suggests that one-port VATS may have certain advantages over three-port VATS for PSP. More large-scale and high-quality studies are needed for authentication.

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Acknowledgments

This work was supported by the National Key Clinical Construction Programs of China (2012) No. 649.

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Correspondence to Tao Jiang.

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Disclosures

Wu Xu, Yang Wang, Jianping Song, Lanying Mo, and Tao Jiang have no conflicts of interest to disclose.

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Xu, W., Wang, Y., Song, J. et al. One-port video-assisted thoracic surgery versus three-port video-assisted thoracic surgery for primary spontaneous pneumothorax: a meta-analysis. Surg Endosc 31, 17–24 (2017). https://doi.org/10.1007/s00464-016-4940-8

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  • DOI: https://doi.org/10.1007/s00464-016-4940-8

Keywords

  • One-port VATS
  • Three-port VATS
  • PSP
  • Meta-analysis
  • Cohort study