ZENG Weiqiang 1 , DANG Haili 2 , GOU Yunjiu 3
  • 1. The first Clinical Medical College of Gansu University of Chinese Medicine, Lanzhou, 730000, P. R. China;
  • 2. Department of Gastroenterology, Longnan Hospital of Traditional Chinese Medicine, Longnan, 746000, Gansu, P. R. China;
  • 3. Department of Thoracic Surgery, Gansu Provincial Hospital, Lanzhou, 730000, P. R. China;
GOU Yunjiu, Email: gouyunjiu@163.com
Segmentectomy; lobectomy; non-small cell lung cancer; robot-assisted thoracoscopic surgery; video-assisted thoracoscopic surgery; systematic review/meta-analysis
10.7507/1007-4848.202302026
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Objective To systematic evaluation of the difference in clinical outcomes between minimally invasive lung segment resection and lobectomy resection for stageⅠA non-small cell lung cancer (NSCLC) in order to provide reference for clinical application. Methods Online databases including The Cochrane Library、PubMed、EMbase、Web of Science、Sinomed、CNKI、WanFangwere searched from inception to January 21, 2023 by two researchers independently. The quality of the included literature was evaluated using the Newcastle-Ottawa Scale (NOS). The prognostic indicators included the overall survival (OS), disease-free survival (DFS) and recurrence-free survival (RFS). The meta-analysis was performed by STATA 14.0. Results A total of 13 studies with 1853 patients were enrolled in the final study, with NOS scores≥7 points. The results of meta-analysis showed that compared with the MILLR group, the blood loss was less [SMD=−0.36, 95%CI (−0.49, −0.23), P=0.000], postoperative drainage tube retention time [SMD=−0.34, 95%CI (−0.62, −0.05), P=0.019] and hospitalization time [SMD=−0.28, 95%CI (−0.40, −0.15), P=0.000] were shorter in the MILSR group. More lymph nodes [SMD=−0.65, 95%CI (−0.78, −0.53), P=0.000] and shorter operation time [SMD=0.20, 95%CI (0.07, 0.33), P=0.003] were found in the MILLR group. There were no significant differences in the incidence of postoperative complications, postoperative recurrence rate, DFS or RFS between the two groups. Conclusion  Although the number of lymph nodes removed by MILSR is limited compared with MILLR, it does not affect the prognosis. MILSR has advantages in reducing intraoperative blood loss and shortening postoperative catheter time and hospital stay. For the surgical treatment of stageⅠA NSCLC, MILSR may be a more appropriate surgical approach.