Risk factors for conversion from minimally invasive surgery to thoracotomy in patients with lung cancer: outcomes from a pooled analysis.

Abstract

The purpose of this study is to explore the risk factors for conversion from minimally invasive surgery to thoracotomy in patients with lung cancer through meta-analytic approach, and provide a better evidence-based basis for clinicians to perform surgery. We conducted a comprehensive search across databases including PubMed, Embase, Web of Science, and the Cochrane Library database to identify relevant English-language studies published up to February 2024. The pooled effect estimate was calculated using the odds ratio (OR) and a 95% confidence interval (CI). We also conducted sensitivity, subgroup, and publication bias tests. Meta-analysis was performed by using stata18MP software. The study was registered with PROSPERO(ID: CRD42024524790). We included a total of 8 studies. We discovered that gender (OR: 1.58; 95% CI: 1.23-2.03; P < 0.001), chronic obstructive pulmonary disease (COPD) (OR: 1.13; 95% CI: 1.04-1.23; P = 0.005), location of the tumor (OR: 1.21; 95% CI: 1.12-1.31; P < 0.001) were all linked to an increased risk of conversion. Additionally, the type of surgery (OR: 0.14; 95% CI: 0.05-0.39; P < 0.001) was associated with a reduced risk of conversion. Nevertheless, age, smoking, and obesity showed no association with the risk of conversion. The current meta-analysis suggests that the male gender, COPD, upper lobe tumor location, and the video-assisted approach are risk factors for conversion from minimally invasive surgery to thoracotomy in patients with lung cancer. More high-quality studies are required to validate the above results due to the limited number and types of studies included.