Comparative efficacy of uniportal and multiportal robotic-assisted thoracoscopic surgery for non-small cell lung cancer: a systematic review and meta-analysis.
{"title":"Comparative efficacy of uniportal and multiportal robotic-assisted thoracoscopic surgery for non-small cell lung cancer: a systematic review and meta-analysis.","authors":"Zhijing He, Zunhui Wan, Ye Hu","doi":"10.21037/jtd-2026-1982","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Currently, the comparative efficacy of different robotic surgical systems in the treatment of lung cancer remains unclear. This study aimed to systematically evaluate the differences in efficacy between uniportal robotic-assisted thoracoscopic surgery (URATS) and multiportal robotic-assisted thoracoscopic surgery (MRATS) for the treatment of non-small cell lung cancer (NSCLC).</p><p><strong>Methods: </strong>PubMed, Cochrane Library, Web of Science, and Embase were searched from database inception to March 2026 following standardized retrieval procedures. Two authors independently performed literature retrieval, preliminary screening, full-text reassessment, raw data extraction, and cross-checking. The Newcastle-Ottawa Scale (NOS) was used to assess the quality of the included studies, and all statistical analyses were performed using Stata 17.0. This study has been registered on the INPLASY platform (protocol registration number: INPLASY202670008).</p><p><strong>Results: </strong>Nine studies involving 1,827 patients were ultimately included. NOS assessment indicated that all included studies were of moderate-to-high quality. The pooled meta-analysis showed that, compared with MRATS, URATS was associated with a longer operative time [weighted mean difference (WMD) =14.70, 95% confidence interval (95% CI): 6.06-23.35, P=0.04, I<sup>2</sup>=24.5%] but a shorter length of hospital stay (WMD =-1.07, 95% CI: -1.36 to -0.77), P<0.01, I<sup>2</sup>=43.3%). No significant differences were observed in 1-year all-cause mortality, infection, air leak, hemothorax, duration of chest tube drainage, intraoperative blood loss, or number of dissected lymph nodes.</p><p><strong>Conclusions: </strong>Compared with MRATS, URATS for NSCLC was associated with a longer operative time but a shorter hospital stay, while no statistically significant differences were observed in the other assessed outcomes. These findings suggest that URATS may be a feasible minimally invasive surgical approach for NSCLC, although further prospective studies are warranted.</p>","PeriodicalId":17542,"journal":{"name":"Journal of thoracic disease","volume":"18 9","pages":"1026"},"PeriodicalIF":2.3000,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13655898/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of thoracic disease","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.21037/jtd-2026-1982","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2026/8/28 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"RESPIRATORY SYSTEM","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Currently, the comparative efficacy of different robotic surgical systems in the treatment of lung cancer remains unclear. This study aimed to systematically evaluate the differences in efficacy between uniportal robotic-assisted thoracoscopic surgery (URATS) and multiportal robotic-assisted thoracoscopic surgery (MRATS) for the treatment of non-small cell lung cancer (NSCLC).
Methods: PubMed, Cochrane Library, Web of Science, and Embase were searched from database inception to March 2026 following standardized retrieval procedures. Two authors independently performed literature retrieval, preliminary screening, full-text reassessment, raw data extraction, and cross-checking. The Newcastle-Ottawa Scale (NOS) was used to assess the quality of the included studies, and all statistical analyses were performed using Stata 17.0. This study has been registered on the INPLASY platform (protocol registration number: INPLASY202670008).
Results: Nine studies involving 1,827 patients were ultimately included. NOS assessment indicated that all included studies were of moderate-to-high quality. The pooled meta-analysis showed that, compared with MRATS, URATS was associated with a longer operative time [weighted mean difference (WMD) =14.70, 95% confidence interval (95% CI): 6.06-23.35, P=0.04, I2=24.5%] but a shorter length of hospital stay (WMD =-1.07, 95% CI: -1.36 to -0.77), P<0.01, I2=43.3%). No significant differences were observed in 1-year all-cause mortality, infection, air leak, hemothorax, duration of chest tube drainage, intraoperative blood loss, or number of dissected lymph nodes.
Conclusions: Compared with MRATS, URATS for NSCLC was associated with a longer operative time but a shorter hospital stay, while no statistically significant differences were observed in the other assessed outcomes. These findings suggest that URATS may be a feasible minimally invasive surgical approach for NSCLC, although further prospective studies are warranted.
期刊介绍：
The Journal of Thoracic Disease (JTD, J Thorac Dis, pISSN: 2072-1439; eISSN: 2077-6624) was founded in Dec 2009, and indexed in PubMed in Dec 2011 and Science Citation Index SCI in Feb 2013. It is published quarterly (Dec 2009- Dec 2011), bimonthly (Jan 2012 - Dec 2013), monthly (Jan. 2014-) and openly distributed worldwide. JTD received its impact factor of 2.365 for the year 2016. JTD publishes manuscripts that describe new findings and provide current, practical information on the diagnosis and treatment of conditions related to thoracic disease. All the submission and reviewing are conducted electronically so that rapid review is assured.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
