MTP3.03 Comparison of perioperative outcomes between video-Assisted and robotic-assisted thoracic Surgery: A Systematic review and meta-Analysis

Abstract Objective This meta-analysis aims to compare the perioperative outcomes of video-assisted thoracic surgery (VATS) and robotic-assisted thoracic surgery (RATS). Methods Randomized controlled trials (RCTs) reporting perioperative outcomes in patients undergoing VATS and RATS were identified from electronic medical databases. The meta-analysis was conducted following Cochrane Collaboration guidelines using RevMan version 5 software. A total of three RCTs, comprising 483 patients, were included in the analysis. Using a random-effects model, the operation duration showed no significant difference between video-assisted thoracoscopic surgery (VATS) and robotic-assisted thoracoscopic surgery (RATS). The mean difference (MD) was -4.98 minutes, with a 95% confidence interval (CI) ranging from -35.18 to 25.22 (Z = 0.32; P = 0.75). However, there was significant heterogeneity among the studies. Similarly, the length of hospital stay was comparable between the two approaches, with an MD of 0.39 days (95% CI: -0.45 to 1.23; Z = 0.90; P = 0.37). Postoperative complications were also statistically similar, with an odds ratio (OR) of 1.11 (95% CI: 0.47 to 2.62; Z = 0.23; P = 0.82), but high heterogeneity was observed in this analysis. The risk of conversion to open surgery did not differ significantly between RATS and VATS, with an OR of 1.20 (95% CI: 0.51 to 2.83; Z = 0.43; P = 0.67). Importantly, no heterogeneity was observed in this comparison. Conclusion RATS does not demonstrate superiority over VATS across the analysed perioperative variables. The observed heterogeneity underscores the need for a large, multicentre RCT to validate these findings.