BACKGROUND It has been widely accepted that video-assisted thoracoscopic surgery (VATS) lobectomy is superior to conventional open thoracotomy lobectomy in many aspects. However, the direct comparison between VATS and Muscle-sparing thoracotomy (MST) has not been widely conducted. We aimed to compare the perioperative outcomes in non-small cell lung cancer (NSCLC) patients following VATS and MST. METHODS PubMed, EMBASE, the Cochrane Library and Web of Science were searched for relevant studies. The retrieval time was up to April 24, 2019. Studies investigating the comparison of video-assisted thoracoscopy and muscle-sparing thoracotomy were included in our meta-analysis. Odds ratio and mean differences with 95% confidential interval were applied to determine the effectiveness of dichotomous or continuous variables respectively. RESULTS A total of 10 studies were included with 1514 patients. Compared with MST, the incidence of postoperative complications in VATS [OR = 0.54; 95%CI(0.4, 0.73); P < 0.001] and the hospital stay [MD = -1.5; 95%CI(- 2.28, - 0.73); P = 0.0001] decreased significantly, chest tube drainage time [MD = -0.71; 95%CI(- 1.18, - 0.24); P = 0.003] were shorter and the intraoperative blood loss [MD = - 43.87; 95%CI(- 73.66, - 14.08); P = 0.004] were less in VATS group. VATS also showed a relatively longer operative time [MD = 17.11; 95%CI(2.38, 31.85); P = 0.02]. However, no significant differences were observed in numbers of resected lymph nodes, postoperative mortality, postoperative pneumonia and postoperative bleeding. CONCLUSION Compared with MST, VATS was associated with lower incidence of postoperative complications, shorter length of hospital stay, less intraoperative blood loss and less chest tube drainage, which showed that VATS was a comparable method to MST. Meanwhile, these results should be further conformed by more randomized control trials.

中文翻译：

---

非小细胞肺癌电视辅助胸腔镜手术与保肌开胸术：系统评价和荟萃分析。

背景技术已经广泛接受视频辅助胸腔镜手术（VATS）肺叶切除术在许多方面优于传统的开胸肺叶切除术。但是，VATS与保留肌肉的开胸手术（MST）之间的直接比较尚未广泛进行。我们旨在比较VATS和MST后非小细胞肺癌（NSCLC）患者的围手术期结局。方法检索PubMed，EMBASE，Cochrane图书馆和Web of Science进行相关研究。检索时间截止至2019年4月24日。我们的荟萃分析包括研究比较了电视胸腔镜和保胸开胸手术的比较。应用机率比和均值差（具有95％的机密区间）分别确定二分变量或连续变量的有效性。结果共纳入10项研究，共1514例患者。与MST相比，VATS术后并发症发生率[OR = 0.54; 95％CI（0.4，0.73）; P <0.001]和住院天数[MD = -1.5；95％CI（-2.28，-0.73）; P = 0.0001]明显下降，胸管引流时间[MD = -0.71; 95％CI（-1.18，-0.24）; P = 0.003]更短，术中失血[MD =-43.87； P = 0.003]。95％CI（-73.66，-14.08）; P = 0.004]在VATS组中较少。VATS还显示出相对更长的手术时间[MD = 17.11; 95％CI（2.38，31.85）; P = 0.02]。然而，在切除的淋巴结数目，术后死亡率，术后肺炎和术后出血方面没有观察到显着差异。结论VATS与MST相比，术后并发症发生率较低，住院时间短，术中失血少，胸管引流少，这表明VATS是MST的可比方法。同时，这些结果应通过更多的随机对照试验进一步证实。