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Abstract：
OBJECTIVE: To compare the effectiveness of single-port and double-port thoracoscopic lobectomy in the treatment of non-small cell lung cancer (NSCLC) using meta-analysis.
METHODS: We systematically searched Pubmed, Embase, and Cochrane Library databases to collect literature on single-hole and double-hole thoracoscopic lobectomy for NSCLC with the end date of August 2022. Keywords included \"thoracoscopy\", \"lobectomy\", and \"non-small cell lung cancer\". Two authors independently conducted literature screening, data extraction, and quality evaluation. The quality evaluation tools were the Cochrane bias risk assessment tool and the Newcastle-Ottawa scale. Meta-analysis was performed using RevMan5.3 software. The odds ratio (OR), weighted mean difference (WMD), and 95% Cl were calculated using a fixed-effects model or random-effect model as appropriate.
RESULTS: Ten studies were included. These included two randomized controlled studies and eight cohort studies. 1800 sick persons were included in the survey. Among them, 976 sick people underwent single-hole thoracoscopic lobectomy (single-hole group), and 904 had double-hole thoracoscopic lobectomy (double-hole group). The results of the meta-analysis are as follows. The intraoperative bleeding volume [WMD = -13.75, 95% CI (-18.47, -9.03), P < 0.001], postoperative 24 h VAS score [WMD = -0.60, 95% CI (-0.75, -0.46), P < 0.001], and postoperative hospital stay time [WMD = -0.33, 95% CI (-0.54, -0.11), P = 0.0003] in the single-hole group was less than that in the double-hole group. The amount of dissected lymph nodes in the double-hole group was more than that in the single-hole group [WMD = 0.50, 95% CI (0.21, 0.80), P = 0.0007]. In both groups, operative time [WMD = 1.00, 95% CI (-9.62, 11.62), P = 0.85], intraoperative conversion rate [OR = 1.07, 95% CI (0.55, 2.08), P = 0.85], postoperative drainage time [WMD = -0.18, 95% CI (-0.52, -0.17), P = 0.32], and postoperative complications rate [OR = 0.89, 95% CI (0.65, 1.22), P = 0.46] had no statistical significance.
CONCLUSIONS: Single-hole thoracoscopic lobectomy has advantages in reducing intraoperative bleeding volume, alleviating early postoperative pain, and shortening postoperative hospital stay time. Double-hole thoracoscopic lobectomy has advantages in lymph node dissection. Both methods are equally safe and feasible for NSCLC.
METHODS: We systematically searched Pubmed, Embase, and Cochrane Library databases to collect literature on single-hole and double-hole thoracoscopic lobectomy for NSCLC with the end date of August 2022. Keywords included \"thoracoscopy\", \"lobectomy\", and \"non-small cell lung cancer\". Two authors independently conducted literature screening, data extraction, and quality evaluation. The quality evaluation tools were the Cochrane bias risk assessment tool and the Newcastle-Ottawa scale. Meta-analysis was performed using RevMan5.3 software. The odds ratio (OR), weighted mean difference (WMD), and 95% Cl were calculated using a fixed-effects model or random-effect model as appropriate.
RESULTS: Ten studies were included. These included two randomized controlled studies and eight cohort studies. 1800 sick persons were included in the survey. Among them, 976 sick people underwent single-hole thoracoscopic lobectomy (single-hole group), and 904 had double-hole thoracoscopic lobectomy (double-hole group). The results of the meta-analysis are as follows. The intraoperative bleeding volume [WMD = -13.75, 95% CI (-18.47, -9.03), P < 0.001], postoperative 24 h VAS score [WMD = -0.60, 95% CI (-0.75, -0.46), P < 0.001], and postoperative hospital stay time [WMD = -0.33, 95% CI (-0.54, -0.11), P = 0.0003] in the single-hole group was less than that in the double-hole group. The amount of dissected lymph nodes in the double-hole group was more than that in the single-hole group [WMD = 0.50, 95% CI (0.21, 0.80), P = 0.0007]. In both groups, operative time [WMD = 1.00, 95% CI (-9.62, 11.62), P = 0.85], intraoperative conversion rate [OR = 1.07, 95% CI (0.55, 2.08), P = 0.85], postoperative drainage time [WMD = -0.18, 95% CI (-0.52, -0.17), P = 0.32], and postoperative complications rate [OR = 0.89, 95% CI (0.65, 1.22), P = 0.46] had no statistical significance.
CONCLUSIONS: Single-hole thoracoscopic lobectomy has advantages in reducing intraoperative bleeding volume, alleviating early postoperative pain, and shortening postoperative hospital stay time. Double-hole thoracoscopic lobectomy has advantages in lymph node dissection. Both methods are equally safe and feasible for NSCLC.
摘要：
目的：采用Meta分析比较单孔与双孔胸腔镜肺叶切除术治疗非小细胞肺癌(NSCLC)的疗效。
方法：我们系统地搜索了Pubmed，Embase,和Cochrane图书馆数据库收集关于单孔和双孔胸腔镜肺叶切除术治疗NSCLC的文献，截止日期为2022年8月。关键词包括“胸腔镜”，“肺叶切除术”，和“非小细胞肺癌”。两位作者独立进行文献筛选,数据提取,和质量评估。质量评估工具为Cochrane偏差风险评估工具和纽卡斯尔-渥太华量表。采用RevMan5.3软件进行Meta分析。赔率比(OR)，加权平均差(WMD)，和95%Cl使用固定效应模型或随机效应模型计算。
结果：纳入10项研究。其中包括两项随机对照研究和八项队列研究。1800名病人被纳入调查。其中,976例患者行单孔胸腔镜肺叶切除术（单孔组），904例进行了双孔胸腔镜肺叶切除术（双孔组）。荟萃分析结果如下。术中出血量[WMD=-13.75,95%CI(-18.47,-9.03),P<0.001],术后24hVAS评分[WMD=-0.60，95%CI（-0.75，-0.46），P<0.001],和术后住院时间[WMD=-0.33，95%CI(-0.54，-0.11)，单孔组P=0.0003]小于双孔组。双孔组淋巴结清扫量多于单孔组[WMD=0.50,95%CI(0.21,0.80),P=0.0007]。在这两组中,手术时间[WMD=1.00,95%CI(-9.62,11.62),P=0.85],术中转换率[OR=1.07，95%CI(0.55，2.08)，P=0.85],术后引流时间[WMD=-0.18,95%CI(-0.52,-0.17),P=0.32],术后并发症发生率[OR=0.89,95%CI(0.65,1.22),P=0.46]无统计学意义。
结论：单孔胸腔镜肺叶切除术在减少术中出血量方面具有优势，减轻术后早期疼痛，缩短术后住院时间。双孔胸腔镜肺叶切除术在淋巴结清扫方面具有优势。两种方法对于NSCLC同样安全可行。
方法：我们系统地搜索了Pubmed，Embase,和Cochrane图书馆数据库收集关于单孔和双孔胸腔镜肺叶切除术治疗NSCLC的文献，截止日期为2022年8月。关键词包括“胸腔镜”，“肺叶切除术”，和“非小细胞肺癌”。两位作者独立进行文献筛选,数据提取,和质量评估。质量评估工具为Cochrane偏差风险评估工具和纽卡斯尔-渥太华量表。采用RevMan5.3软件进行Meta分析。赔率比(OR)，加权平均差(WMD)，和95%Cl使用固定效应模型或随机效应模型计算。
结果：纳入10项研究。其中包括两项随机对照研究和八项队列研究。1800名病人被纳入调查。其中,976例患者行单孔胸腔镜肺叶切除术（单孔组），904例进行了双孔胸腔镜肺叶切除术（双孔组）。荟萃分析结果如下。术中出血量[WMD=-13.75,95%CI(-18.47,-9.03),P<0.001],术后24hVAS评分[WMD=-0.60，95%CI（-0.75，-0.46），P<0.001],和术后住院时间[WMD=-0.33，95%CI(-0.54，-0.11)，单孔组P=0.0003]小于双孔组。双孔组淋巴结清扫量多于单孔组[WMD=0.50,95%CI(0.21,0.80),P=0.0007]。在这两组中,手术时间[WMD=1.00,95%CI(-9.62,11.62),P=0.85],术中转换率[OR=1.07，95%CI(0.55，2.08)，P=0.85],术后引流时间[WMD=-0.18,95%CI(-0.52,-0.17),P=0.32],术后并发症发生率[OR=0.89,95%CI(0.65,1.22),P=0.46]无统计学意义。
结论：单孔胸腔镜肺叶切除术在减少术中出血量方面具有优势，减轻术后早期疼痛，缩短术后住院时间。双孔胸腔镜肺叶切除术在淋巴结清扫方面具有优势。两种方法对于NSCLC同样安全可行。
