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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

Meta-analyses of operative mortality.
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pone.0124512.g002: Meta-analyses of operative mortality.

Mentions: Operative mortality was 2.5% (0% to 8.2%) and 7.8% (0% to 14.3%) in patients undergoing VATS lobectomy and open lobectomy, respectively. Meta-analyses demonstrated a trend towards reduced risk of operative mortality in patients undergoing VATS lobectomy (RR = 0.51; 95% CI 0.24 to 1.06; p = 0.07; Fig 2). The publication of Paul et al. was not included in this meta-analysis because there was no operative mortality in either the intervention or control groups [26]. In addition, the VATS group (n = 49) in the study of Lau et al. included 27 patients undergoing open segmentectomy [4]. The sensitivity analysis, from which the study of Lau et al. was removed, did not show a difference between the two approaches (RR = 0.48; 95% CI, 0.19 to 1.20; p = 0.12).


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

Zhang R, Ferguson MK - PLoS ONE (2015)

Meta-analyses of operative mortality.
© Copyright Policy
Related In: Results  -  Collection

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

pone.0124512.g002: Meta-analyses of operative mortality.
Mentions: Operative mortality was 2.5% (0% to 8.2%) and 7.8% (0% to 14.3%) in patients undergoing VATS lobectomy and open lobectomy, respectively. Meta-analyses demonstrated a trend towards reduced risk of operative mortality in patients undergoing VATS lobectomy (RR = 0.51; 95% CI 0.24 to 1.06; p = 0.07; Fig 2). The publication of Paul et al. was not included in this meta-analysis because there was no operative mortality in either the intervention or control groups [26]. In addition, the VATS group (n = 49) in the study of Lau et al. included 27 patients undergoing open segmentectomy [4]. The sensitivity analysis, from which the study of Lau et al. was removed, did not show a difference between the two approaches (RR = 0.48; 95% CI, 0.19 to 1.20; p = 0.12).

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