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The following is a summary of “Meta-analysis of clinical efficacy of thoracoscopy and robotic surgery in the treatment of mediastinal tumors,” published in the February 2024 issue of Surgery by Dang et al.
This meta-analysis comprehensively compares the clinical efficacy of thoracoscopy and robotic surgery in managing mediastinal tumors.
Researchers conducted a systematic search of PubMed, Embase, The Cochrane Library, and Web of Science databases up to September 2023, identifying studies that compared the clinical outcomes of video-assisted thoracic surgery (VATS) and robot-assisted thoracic surgery (RATS) for mediastinal tumor treatment. Two independent evaluators screened the literature, extracted data, and assessed bias risk. Meta-analysis was conducted using RevMan 5.4.
Nineteen articles comprising 3,517 patients were included. Meta-analysis revealed several advantages of RATS over VATS: reduced intraoperative bleeding (MD = − 5.20, 95%CI − 9.28 to − 1.12, P = 0.01), lower conversion to thoracotomy rates (OR = 0.41, 95%CI 0.23 to 0.72, P = 0.002), decreased total postoperative complication rates (OR = 0.57, 95%CI 0.34 to 0.95, P = 0.03), shorter postoperative drainage time (MD = − 0.72, 95%CI − 1.13 to − 0.32, P = 0.0004), and reduced postoperative hospital stay (MD = − 0.90, 95%CI − 1.16 to − 0.65, P < 0.001). However, no significant differences were observed in tumor size (MD = − 0.02, 95%CI − 0.33 to 0.30, P = 0.91) or operation time (MD = 0.17, 95%CI − 7.61 to 7.94, P = 0.97). Notably, RATS was associated with higher hospitalization costs (MD = 2634.75, 95%CI 991.62 to 4277.88, P = 0.002) compared to VATS.
Robot-assisted mediastinal tumor resection surgery demonstrates superior outcomes in terms of intraoperative bleeding, conversion to thoracotomy rate, postoperative complications, drainage time, and hospital stay compared to thoracoscopic-assisted surgery. However, it incurs higher hospitalization costs. The observed tumor size and operation time similarity between the two procedures underscores their clinical comparability. These findings offer valuable insights for clinicians in selecting the optimal surgical approach for mediastinal tumor management.
Source: wjso.biomedcentral.com/articles/10.1186/s12957-024-03325-5