Systematic review and meta-Analysis of video-Assisted thoracoscopic surgery segmentectomy versus lobectomy for stage i non-small cell lung cancer

Abstract

Background: Whether video-Assisted thoracoscopic surgery (VATS) segmentectomy and VATS lobectomy provide similar perioperative and oncological outcomes in stage I non-small cell lung cancer (NSCLC) is still controversial. Methods: Meta-Analysis of 12 studies comparing outcomes after VATS lobectomy and VATS segmentectomy for stage I NSCLC. Data were analyzed by the RevMan 5.3 software. Results: Disease-free survival (HR 1.19, 95% CI 0.89 to 1.33, P = 0.39), overall survival (HR 1.11, 95% CI 0.89 to 1.38, P = 0.36), postoperative complications (OR = 1.10, 95% CI 0.69 to 1.75, P = 0.7), intraoperative blood loss (MD = 3.87, 95% CI-10.21 to 17.94, P = 0.59), operative time (MD = 10.89, 95% CI-13.04 to 34.82, P = 0.37), air leak > 5 days (OR = 1.20, 95% CI 0.66 to 2.17, P = 0.55), and in-hospital mortality (OR = 1.67, 95% CI 0.39 to 7.16, P = 0.49) were comparable between the groups. Postoperative hospital stay (MD =-0.69, 95% CI-1.19 to-0.19, P = 0.007) and number of dissected lymph nodes (MD =-6.44, 95%CI-9.49 to-3.40, P < 0.0001) were significantly lower in VATS segmentectomy patients. Conclusions: VATS segmentectomy and VATS lobectomy provide similar oncological and perioperative outcomes for stage I NSCLC patients. This systematic review was registered on PROSPERO and can be accessed at http://www.crd.york.ac.uk/PROSPERO/display_record.php?ID = CRD42019133398.