Single-incision versus conventional three-port video-assisted surgery in the treatment of pneumothorax: a systematic review and meta-analysis.

OBJECTIVES: Single-incision thoracoscopic surgery (SITS) has been applied in the treatment of pneumothorax. To establish the feasibility of SITS in comparison with conventional three-port video-assisted thoracoscopic surgery (3P-VATS), we conducted this meta-analysis.

METHODS: Relevant studies were searched in PubMed, Cochrane Library, SpringerLink and ScienceDirect. Studies that compared the outcomes between SITS and 3P-VATS were included for analysis.

RESULTS: Nine eligible studies with 768 participants were included. Our analysis indicates that when compared with 3P-VATS, SITS was associated with less postoperative pain (weight mean difference, WMD = -0.67, 95% confidence interval, CI = -1.11 to -0.22, P = 0.004 for postoperative pain at 24 h; WMD = -0.62, 95% CI = -1.11 to -0.12, P = 0.01 for postoperative pain at 72 h), lower paraesthesia rate (odds ratio, OR = 0.09, 95% CI = 0.04-0.21, P = 0.01) and shorter hospital stay (WMD = -0.34 days, 95% CI = -0.60 to -0.08, P = 0.01). No significant association was found in operative time, mean duration of chest tube, complications and recurrence rates.

CONCLUSIONS: SITS was a safe and efficient procedure for the treatment of pneumothorax with less postoperative pain and faster recovery. The complication and recurrence rates were equivalent when compared with 3P-VATS.