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Video-Assisted versus Open Lobectomy in Patients with Compromised Lung Function: A Literature Review and Meta-Analysis.

Zhang R, Ferguson MK - PLoS ONE (2015)

Bottom Line: Study selection, data collection and critical assessment of the included studies were performed according to the recommendations of the Cochrane Collaboration.VATS lobectomy patients experienced significantly lower pulmonary morbidity (RR = 0.45; 95% CI, 0.30 to 0.67; p = 0.0001), somewhat reduced operative mortality (RR = 0.51; 95% CI, 0.24 to 1.06; p = 0.07), but no significant difference in overall morbidity (RR = 0.68; 95% CI, 0.41 to 1.14; p = 0.14).The existing data suggest that VATS lobectomy is associated with lower risk for pulmonary morbidity compared with open lobectomy in lung cancer patients with compromised lung function.

View Article: PubMed Central - PubMed

Affiliation: Division of Thoracic Surgery, Klinik Schillerhoehe, Center for Pneumology and Thoracic Surgery, Teaching Hospital of the University of Tuebingen, Gerlingen, Germany.

ABSTRACT

Background: It has been suggested that video-assisted (VATS) lobectomy is safer than open lobectomy in patients with compromised lung function, but data regarding this are limited. We assessed acute outcomes of VATS compared to open lobectomy in these high-risk patients using a systematic literature review and meta-analysis of data.

Methods: The databases PubMed and Scopus were searched for studies published between 2000 and 2013 that reported mortality and morbidity of VATS in high-risk lung cancer patients defined as having compromised pulmonary or cardiopulmonary function. Study selection, data collection and critical assessment of the included studies were performed according to the recommendations of the Cochrane Collaboration.

Results: Three case-control studies and three case series that included 330 VATS and 257 open patients were identified for inclusion. Operative mortality, overall morbidity and pulmonary morbidity were 2.5%, 39.3%, 26.2% in VATS patients and 7.8%, 57.5%, 45.5% in open lobectomy group, respectively. VATS lobectomy patients experienced significantly lower pulmonary morbidity (RR = 0.45; 95% CI, 0.30 to 0.67; p = 0.0001), somewhat reduced operative mortality (RR = 0.51; 95% CI, 0.24 to 1.06; p = 0.07), but no significant difference in overall morbidity (RR = 0.68; 95% CI, 0.41 to 1.14; p = 0.14).

Conclusion: The existing data suggest that VATS lobectomy is associated with lower risk for pulmonary morbidity compared with open lobectomy in lung cancer patients with compromised lung function.

No MeSH data available.


Related in: MedlinePlus

Diagram of literature selection.
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pone.0124512.g001: Diagram of literature selection.

Mentions: A total of 368 and 256 publications were identified in PubMed and Scopus databases, respectively. After discarding duplicates, 526 publications were screened based on title and abstract. Of those, 142 publications were further assessed for eligibility based on full-text articles. Six publications ultimately were included for data collection and critical assessment [3,4,16,20,22,26]. A list identifying reasons for exclusion of the 136 publications is available as supporting information (S1 Table [https://drive.google.com/folderview?id=0B8uBM3vcuLv8d2p1cEFBc3NGZU0&usp=sharing]). No additional eligible publication was identified after assessing review articles. The diagram of literature selection is depicted in Fig 1. The publications were excluded mainly because they did not involve the population of interest (n = 316, 50.6%) or the clinical data of the population of interest were not extractable (n = 88, 14.1%).


Video-Assisted versus Open Lobectomy in Patients with Compromised Lung Function: A Literature Review and Meta-Analysis.

Zhang R, Ferguson MK - PLoS ONE (2015)

Diagram of literature selection.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4493021&req=5

pone.0124512.g001: Diagram of literature selection.
Mentions: A total of 368 and 256 publications were identified in PubMed and Scopus databases, respectively. After discarding duplicates, 526 publications were screened based on title and abstract. Of those, 142 publications were further assessed for eligibility based on full-text articles. Six publications ultimately were included for data collection and critical assessment [3,4,16,20,22,26]. A list identifying reasons for exclusion of the 136 publications is available as supporting information (S1 Table [https://drive.google.com/folderview?id=0B8uBM3vcuLv8d2p1cEFBc3NGZU0&usp=sharing]). No additional eligible publication was identified after assessing review articles. The diagram of literature selection is depicted in Fig 1. The publications were excluded mainly because they did not involve the population of interest (n = 316, 50.6%) or the clinical data of the population of interest were not extractable (n = 88, 14.1%).

Bottom Line: Study selection, data collection and critical assessment of the included studies were performed according to the recommendations of the Cochrane Collaboration.VATS lobectomy patients experienced significantly lower pulmonary morbidity (RR = 0.45; 95% CI, 0.30 to 0.67; p = 0.0001), somewhat reduced operative mortality (RR = 0.51; 95% CI, 0.24 to 1.06; p = 0.07), but no significant difference in overall morbidity (RR = 0.68; 95% CI, 0.41 to 1.14; p = 0.14).The existing data suggest that VATS lobectomy is associated with lower risk for pulmonary morbidity compared with open lobectomy in lung cancer patients with compromised lung function.

View Article: PubMed Central - PubMed

Affiliation: Division of Thoracic Surgery, Klinik Schillerhoehe, Center for Pneumology and Thoracic Surgery, Teaching Hospital of the University of Tuebingen, Gerlingen, Germany.

ABSTRACT

Background: It has been suggested that video-assisted (VATS) lobectomy is safer than open lobectomy in patients with compromised lung function, but data regarding this are limited. We assessed acute outcomes of VATS compared to open lobectomy in these high-risk patients using a systematic literature review and meta-analysis of data.

Methods: The databases PubMed and Scopus were searched for studies published between 2000 and 2013 that reported mortality and morbidity of VATS in high-risk lung cancer patients defined as having compromised pulmonary or cardiopulmonary function. Study selection, data collection and critical assessment of the included studies were performed according to the recommendations of the Cochrane Collaboration.

Results: Three case-control studies and three case series that included 330 VATS and 257 open patients were identified for inclusion. Operative mortality, overall morbidity and pulmonary morbidity were 2.5%, 39.3%, 26.2% in VATS patients and 7.8%, 57.5%, 45.5% in open lobectomy group, respectively. VATS lobectomy patients experienced significantly lower pulmonary morbidity (RR = 0.45; 95% CI, 0.30 to 0.67; p = 0.0001), somewhat reduced operative mortality (RR = 0.51; 95% CI, 0.24 to 1.06; p = 0.07), but no significant difference in overall morbidity (RR = 0.68; 95% CI, 0.41 to 1.14; p = 0.14).

Conclusion: The existing data suggest that VATS lobectomy is associated with lower risk for pulmonary morbidity compared with open lobectomy in lung cancer patients with compromised lung function.

No MeSH data available.


Related in: MedlinePlus