Three-dimension versus two-dimension video-assisted thoracoscopic surgery for esophageal cancer: a meta-analysis

BACKGROUND: It still remains unclear whether three-dimension (3D) video-assisted thoracoscopic surgery (VATS) for esophageal cancer is safe and reasonable. This meta-analysis aims at assessing the effectiveness and safety of 3D VATS for esophageal cancer in comparison with that of two-dimension (2D) VATS. METHODS: All the relevant data systematically analyzed in this thesis is from PubMed, Embase, The Cochrane Library, Web of Science and clinicaltrials.gov, and the time span for retrieval is from the date of the database establishment to February 2021. The research on the efficacy and safety of 3D VATS for esophageal cancer and 2D VATS is consistent with our meta-analysis. Continuous variables and dichotomy variables are compared using odds ratio, average or standard average differences with 95% confidence interval (95% CI), and P values, respectively. RESULTS: In five studies of this paper, there were 553 patients in total (3D VATS group, n=266 and 2D VATS group, n=287). Patients in the 3D group had shorter operation time [standardized mean difference (SMD) =−0.99, 95% CI: −1.66 to −0.32; P=0.004], and less bleeding (SMD =−0.88, 95% CI: −1.66 to −0.10; P=0.03) than those in the 2D group. The total amount of dissected lymph node and post-operative complications in the 2D group and the 3D group were nearly the same, showing no significant difference. DISCUSSION: The results of this meta-analysis showed that 3D VATS for esophageal cancer will be more applied and developed in the future. REGISTRATION NUMBER OF PROSPERO: CRD42021238863.