Related Experiment Video
Updated: Dec 13, 2025
Author Spotlight: A Non-Intubated Video-Assisted Thoracoscopic Surgery with Multimodal Analgesia and Sevoflurane Inhalation Anesthesia
Published on: May 26, 2023
Survival After Thoracoscopic Surgery or Open Lobectomy: Systematic Review and Meta-Analysis
Daniel Hernandez-Vaquero1, Carlota Vigil-Escalera2, Itzell Pérez-Méndez3
1Institute of Research of The Principado de Asturias, Oviedo, Spain; Department of Medicine, University of Oviedo, Oviedo, Spain; Department of Cardiac Surgery, Central University Hospital of Asturias, Oviedo, Spain.
Background:
Video-assisted thoracoscopic surgery (VATS) has been shown to reduce hospital stays and pain compared with open lobectomy to treat non-small cell lung cancer. Because of the low rate of deaths, it is difficult to show differences in survival in individual studies. The objective of this study was to compare short- and long-term mortality by means of a systematic review and meta-analysis.
Methods:
The reviewers systematically searched studies that compared VATS vs open lobectomy and provided data on 30-day mortality or long-term survival (>5 years). For long-term outcomes, studies included patients with the same cancer stage or, if several stages were included, the studies had to control for cancer stage in their propensity score model. A pooled odds ratio and hazard ratio (HR) was respectively calculated for short- and long-term outcomes.
Results:
A total of 33 works were identified, comprising 61,633 patients. VATS led to lower postoperative mortality (odds ratio, 0.64; 95% confidence interval [CI], 0.56 to 0.73) and higher long-term survival (HR, .88; 95% CI, 0.81 to 0.96). Disease-free survival was similar in both groups (HR, 0.94; 95% CI, 0.80 to 1.10).
Conclusions:
For non-small cell lung cancer treated with lobectomy, VATS was associated with lower postoperative mortality and greater long-term survival compared with open lobectomy. Disease-free survival was similar between both groups.
