Comparative outcomes of video-assisted thoracic surgery versus open thoracic surgery in pediatric pulmonary metastasectomy: a systematic review and meta-analysis
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In brief
In brief
This systematic review compares VATS versus open thoracotomy for removing lung metastases in pediatric cancer patients across 1,541 cases. While survival outcomes were equivalent between approaches, VATS reduced hospital stays by approximately 2 days, supporting its use as a less invasive option when clinically appropriate.
- VATS and open thoracotomy show no significant difference in overall survival or disease-free survival for pediatric pulmonary metastasectomy
- VATS reduces hospital stay by approximately 2 days compared to open thoracotomy in pediatric patients
- Meta-analysis included 1,541 pediatric patients across 4 studies comparing minimally invasive versus open approaches
- VATS offers shorter hospitalization without compromising oncologic outcomes in pediatric metastasectomy cases
- Future prospective studies needed to establish optimal patient selection criteria for VATS versus open approach
Written by the GCMD Library team from the article.
Abstract
This meta-analysis aimed to compare the outcomes of video-assisted thoracic surgery (VATS) and open thoracotomy in pediatric patients undergoing pulmonary metastasectomy for various malignancies. We systematically searched PubMed, Embase, and Cochrane Library databases for studies comparing VATS and open thoracotomy in pediatric patients. The treatment effects for continuous outcomes were compared using mean differences (MDs), and binary endpoints were evaluated using odds ratios (ORs), with 95% confidence intervals (CIs). Heterogeneity was assessed with I2 statistics. Statistical analyses were performed using R software, version 4.4.1. A total of 4 studies involving 1,541 patients were included. There were no significant differences in overall survival (OR 0.65; 95% CI 0.36–1.18; p = 0.16) or disease-free survival (DFS) (OR 1.65; 95% CI 0.88–3.10; p = 0.12) between groups. However, VATS was associated with a significantly reduced length of hospital stay (MD -2.06 days; 95% CI − 2.93 to − 1.20; p < 0.01). This meta-analysis suggests that VATS significantly reduces hospitalization duration compared to open thoracotomy, with no significant difference in survival outcomes. Future prospective studies are needed to validate these findings and optimize patient selection criteria. International Prospective Register of Systematic Reviews; No: CRD42024581284; URL: https://www.crd.york.ac.uk/prospero/.