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Dimitrios E. Magouliotis



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    FP01 - Early Stage/Localized Disease (ID 111)

    • Event: WCLC 2020
    • Type: Posters (Featured)
    • Track: Early Stage/Localized Disease
    • Presentations: 1
    • Moderators:
    • Coordinates: 1/28/2021, 00:00 - 00:00, ePoster Hall
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      FP01.01 - Uniportal Versus Multiportal Video-Assisted Thoracoscopic Surgery for Non-Small Cell Lung Cancer: An Updated Meta-Analysis   (ID 3517)

      00:00 - 00:00  |  Author(s): Dimitrios E. Magouliotis

      • Abstract
      • Slides

      Introduction

      Minimally invasive surgical techniques have become the standard approach for treating patients with non-small cell lung cancer. In this context, the uniportal video-assisted thoracoscopic surgery (UVATS) approach has been proposed as a feasible alternative to the multiport VATS to perform feasibly and safely a wide range of thoracic surgical operations, including lobectomy for non-small cell lung cancer. As the number of studies comparing the feasibility and safety of UVATS and MVATS increases, it is necessary to reevaluate whether the results between the two techniques are at least equivalent. The purpose of the present study was to summarize and analyze the existing data by comparing the surgical outcomes of UVATS and MVATS, in order to provide the best evidence that is currently available.

      Methods

      A thorough literature search was performed in three databases: (i) Pubmed (Medline), (ii) Cochrane Central Register of Controlled Studies (CENTRAL), and (iii) Scopus (ELSEVIER) (last search: April 20th, 2020). Original studies that evaluated perioperative and long-term outcomes of UVATS versus MVATS were identified, from January 1990 to April 2020. The perioperative, along with the oncologic and long-term survival outcomes were calculated according to either a fixed and a random effect model, appropriately. The Q statistics and I2 statistic were used to test for heterogeneity among the studies.

      Results

      Twenty studies were included, incorporating a total of 1,469 patients treated with UVATS and 3,231 treated with MVATS. The incidence of complications was lower in patients treated with UVATS [OR: 0.76 (95% CI: 0.62, 0.93); p=0.008]. The chest tube duration was significantly decreased in the UVATS group (WMD: -0.63 [95% CI:-1.03, -0.23]; p=0.002). L.O.S. was also lower in the UVATS patient group (WMD: -0.54 [-0.94, -0.13]; p=0.009), along with the reported levels of postoperative pain [WMD: -0.57 (95% CI:-0.97, -0.18); p=0.004]. No significant differences were found regarding the M.O.T., mean blood loss, the number of resected lymph nodes, the 30-day mortality, along with the survival at one and three years postoperatively.

      forest plot complications.jpg

      Conclusion

      The present meta-analysis indicates that UVATS is associated with enhanced outcomes in patients undergoing surgery for lung cancer. However, the decision regarding the procedure of choice should be made based on the shared decision-making process. Well-designed, randomized studies, comparing UVATS to MVATS, are necessary to further assess their long-term clinical outcomes.

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