Journal Thoracic Oncology

Abstracts Journal of Thoracic Oncology • Volume 12 Issue S1 January 2017
POSTER SESSION 1 - P1.08: SURGERY
MINIMAL INVASIVE SURGERY –
MONDAY, DECEMBER 5, 2016
P1.08-039 SYSTEMATIC REVIEW AND UPDATED META-ANALYSIS
OF UNIPORTAL VERSUS MULTIPORTAL VIDEO-ASSISTED
THORACOSCOPIC SURGERY FOR LUNG CANCER
Mariusz Kowalewski 1 , Maciej Dancewicz 2 , Mariusz Bella 2 , Tomasz Szczęsny 2 ,
Przemysław Bławat 2 , Marzena Lewandowska 2 , Aleksandra Chrzastek 3 , Janusz
Kowalewski 3
1 Department of Hygiene, Epidemiology and Ergonomics, Division of Ergonomics
and Physical Effort, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus
University in Torun, Bydgoszcz/Poland, 2 Department of Thoracic Surgery and
Tumors, Franciszek Lukaszczyk Memorial Oncological Center in Bydgoszcz,
Bydgoszcz/Poland, 3 Department of Thoracic Surgery and Tumors, Collegium
Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, Bydgoszcz/Poland
Background: Uniportal video-assisted thoracoscopic surgery (VATS) is a
challenging surgical procedure that poses substantial technical difficulties
compared to multiportal VATS but has been associated with favorable
outcomes in studies reported to date. Methods: On-line databases were
screened until June 2016. Meta-analysis aimed to compare clinical outcomes of
uniportal and multiportal VATS lobectomy for patients with lung cancer.
Endpoints assessed included perioperative mortality, operative time and
blood loss; length of hospital stay; duration of postoperative drainage; rates
of conversion to open thoracotomy; number of harvested lymph nodes and
overall morbidity. Risk Ratios (RR)/Mean Difference (MD) and corresponding
95% Confidence Intervals (95%CIs) served as primary statistics. Results:
Twelve studies were included (among them 1 randomized trial) that enrolled
N=2,476 patients. There was no difference in the 30-day mortality: (N=2,476);
RR (95%CIs) 0.32 (0.03-3.01); p=0.32; Event rates: 0.10% (1/1,021) vs 0.07%
(1/1,455); no difference were demonstrated for conversion-to-thoracotomy:
0.91 (0.48-1.73); p=0.77; similarly there were no differences in regard to
operative times: MD (95%CIs): 3.50 ([-12.35]-19.34) min; p=0.67 and blood loss:
-2.15 ([-17.13]-12.83) ml; p=0.78. There was no statistically significant difference
between number of harvested lymph nodes: 18.4±6.6 vs 19.4±8.5; MD
(95%CIs): -0.34 ([-1.39]-0.70) node; p=0.52. Uniportal VATS was associated
with significantly shorter duration of chest tube drainage: -0.61 ([-0.99]-[-
0.23]) days; p=0.002 (Figure 1A); and length of hospital stay: -0.58 ([-0.77]-[-
0.40]) days; p