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Aim <p>This meta-analysis aimed to evaluate and compare the outcomes of video-assisted thoracic surgery (VATS) and open thoracic surgery (OT) in the management of pulmonary echinococcosis.</p> Methods <p>We conducted a comprehensive search of PubMed, Embase, and Cochrane databases for studies comparing VATS and OT. Odds ratios (ORs) for binary outcomes and mean differences (MDs) for continuous variables were calculated with 95% confidence intervals (CIs) using the DerSimonian and Laird random-effects model. Heterogeneity was assessed using I<sup>2</sup> statistics.</p> Results <p>Seven studies involving 2292 patients were included. VATS demonstrated significant advantages over OT, with reductions in intraoperative blood loss (MD − 81.65&#xa0;mL, 95% CI − 129.90 to − 33.40), duration of thoracic drainage (MD − 2.29&#xa0;days, 95% CI − 3.61 to − 0.98), operative time (MD − 45.73&#xa0;min, 95% CI − 68.41 to − 23.05), narcotic use (MD -3.98&#xa0;days, 95% CI − 6.21 to − 1.75), length of hospital stay (MD − 3.66&#xa0;days, 95% CI − 5.66 to − 1.67), postoperative drainage volume (MD − 124.77&#xa0;mL, 95% CI − 206.27 to − 43.27), and visual analogic score pain at 24&#xa0;h after surgery (MD − 2.05 points, 95% CI − 2.40 to − 1.70). However, VATS was associated with a higher incidence of atelectasis (OR 3.27, 95% CI 1.03–10.35). No significant differences were observed in other complications, such as bronchopulmonary fistula, surgical wound infection, prolonged air leak, or failure of lung expansion.</p> Conclusions <p>VATS was associated with perioperative benefits, including reduced recovery times and resource utilization. Nonetheless, the higher risk of atelectasis suggests OT may remain favorable in complex cases requiring broader surgical access. Tailoring the surgical approach to the patient’s needs remains crucial.</p> Trial registry <p>International Prospective Register of Systematic Reviews; Nº: CRD42025630187; URL: <a href="https://www.crd.york.ac.uk/prospero/">https://www.crd.york.ac.uk/prospero/</a>.</p>

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Comparative outcomes video-assisted thoracic surgery versus open thoracic surgery in pulmonary echinococcosis: a systematic review and meta-analysis

  • 期刊论文

  • 发表日期：

    2025年3月18日

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  • Isabella Cabianca Moriguchi Caetano Salvador,
  • Rachid Eduardo Noleto da Nobrega Oliveira,
  • Ingryd de Almeida Silva,
  • Lucas Antônio Fernandes Torres,
  • Maria Tereza Camarotti,
  • Felipe Santos Passos,
  • Alessandro Wasum Mariani

摘要

Aim

This meta-analysis aimed to evaluate and compare the outcomes of video-assisted thoracic surgery (VATS) and open thoracic surgery (OT) in the management of pulmonary echinococcosis.

Methods

We conducted a comprehensive search of PubMed, Embase, and Cochrane databases for studies comparing VATS and OT. Odds ratios (ORs) for binary outcomes and mean differences (MDs) for continuous variables were calculated with 95% confidence intervals (CIs) using the DerSimonian and Laird random-effects model. Heterogeneity was assessed using I2 statistics.

Results

Seven studies involving 2292 patients were included. VATS demonstrated significant advantages over OT, with reductions in intraoperative blood loss (MD − 81.65 mL, 95% CI − 129.90 to − 33.40), duration of thoracic drainage (MD − 2.29 days, 95% CI − 3.61 to − 0.98), operative time (MD − 45.73 min, 95% CI − 68.41 to − 23.05), narcotic use (MD -3.98 days, 95% CI − 6.21 to − 1.75), length of hospital stay (MD − 3.66 days, 95% CI − 5.66 to − 1.67), postoperative drainage volume (MD − 124.77 mL, 95% CI − 206.27 to − 43.27), and visual analogic score pain at 24 h after surgery (MD − 2.05 points, 95% CI − 2.40 to − 1.70). However, VATS was associated with a higher incidence of atelectasis (OR 3.27, 95% CI 1.03–10.35). No significant differences were observed in other complications, such as bronchopulmonary fistula, surgical wound infection, prolonged air leak, or failure of lung expansion.

Conclusions

VATS was associated with perioperative benefits, including reduced recovery times and resource utilization. Nonetheless, the higher risk of atelectasis suggests OT may remain favorable in complex cases requiring broader surgical access. Tailoring the surgical approach to the patient’s needs remains crucial.

Trial registry

International Prospective Register of Systematic Reviews; Nº: CRD42025630187; URL: https://www.crd.york.ac.uk/prospero/.