| Objective: To systematically review the efficacy and safety of roboticassisted thoracic surgery(RATS)and video assisted thoracic surgery(VATS)for patients with non-small cell lung cancer(NSCLC)。Methods: We searched EMbase,The Cochrane Library,Pubmed,Web of Science,CNKI and Wan Fang Data to collect clinical studies about RATS vs.VATS for patients with NSCLC from inception to October 2016.Reviewers independently screened literature,extracted data and assessed the risk of bias of included studies,then meta-analysis was performed by using Stata 15.0software。Results: We finally involved 22 cohort studies and 80 387 patients;among them.The results of meta-analysis showed that there was no obviously different in the operation time(SMD=0.15,95%CI-0.01 to 0.31,P=0.134).And,the cumulative meta-analyses suggested that the incidence was significantly lower in patients who underwent RATS(OR=0.57,95%CI 0.35 to0.93,P=0.072).Meanwhile,Considering the high heterogeneity,subgroup meta-analysis indicated that,when it comes to the recent 5 year’s studies,the hospitalization time was significantly shorter in patients who underwent RATS(SMD=–0.29,95%CI –0.44 to –0.15,P=0.108).In addition,more lymph nodes were retrieved in RATS group,especially compared with uniportal surgery for lung cancer(SMD=–1.48,95%CI 1.22 to 1.74,P=0.94).However,the conversion rate,retrieved lymph node station,days to tube removal and in-hospital mortality rate were not significant differences between both groups。Conclusions: The current meta-analysis indicates that the efficacy and safety of RATS and VATS for NSCLC is equivalence,however the operation time for RATS is longer.Due to the limited quantity and quality of inclued studies,the above conclusions still need to be verified by more high quality studies。... |
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