title: Can lymph node evaluation be performed well by video-assisted thoracic surgery?
abstract: BACKGROUND
  A systemic review was performed to investigate whether video-assisted thoracic surgery (VATS) could achieve equivalent lymph node (LN) evaluation efficacy to thoracotomy.
  
  
  METHODS
  A comprehensive search of PubMed, EMBASE, and Cochrane was performed to identify studies comparing VATS and thoracotomy in LNs and node stations. Mean difference was calculated by Review Manager 5.0 software and Stata 12.
  
  
  RESULTS
  Twenty-four studies met the inclusion criteria of LN evaluation. 2,015 patients were involved in VATS group in contrast to 3,250 patients in thoracotomy group. The same number of total nodes stations (mean difference, 0.09; 95% CI -0.25 to 0.42; P = 0.61) and mediastinal node stations (mean difference, -0.11; 95% CI -0.24 to 0.01; P = 0.08) could be assessed by thoracotomy and VATS. The same number of N1 LNs (mean difference, -0.33; 95% CI -0.70 to 0.05; P = 0.09) could be assessed by both groups. While more total (mean difference, -1.41; 95% CI -1.99 to -0.83; P < 0.00001) and mediastinal LNs (mean difference, -1.03; 95% CI -1.81 to -0.24; P = 0.01) could be harvested by thoracotomy.
  
  
  CONCLUSIONS
  Outcome showed that the same number of total and mediastinal LN stations could be harvested by VATS and OT. The same number of N1 LNs could be harvested by VATS and OT, while less total and mediastinal LNs could be harvested by VATS.
authors.affiliation: Department of Thoracic Surgery, China-Japan Friendship Hospital, No. 2 Yinghua East Street, Chaoyang District, Beijing, 100029, China, doctor_zzr@126.com.
authors.forename: Zhenrong
authors.initials: Z
authors.lastname: Zhang
authors.forename: Hongxiang
authors.initials: H
authors.lastname: Feng
authors.forename: Xiaowei
authors.initials: X
authors.lastname: Wang
authors.forename: Chaoyang
authors.initials: C
authors.lastname: Liang
authors.forename: Deruo
authors.initials: D
authors.lastname: Liu
mesh_terms: D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology* / Q000601:surgery*; D008198:Lymph Nodes / Q000473:pathology*; D009367:Neoplasm Staging; D011013:Pneumonectomy; D011379:Prognosis; D020775:Thoracic Surgery, Video-Assisted; D013908:Thoracotomy
references.citation: Eur J Cardiothorac Surg. 2003 Mar;23(3):397-402
references.pmid: 12614813
references.citation: Chin Med J (Engl). 2012 Feb;125(3):434-9
references.pmid: 22490398
references.citation: JAMA. 2001 Feb 21;285(7):914-24
references.pmid: 11180735
references.citation: J Thorac Cardiovasc Surg. 2010 Apr;139(4):976-81; discussion 981-3
references.pmid: 20172539
references.citation: Ann Thorac Surg. 2007 Jun;83(6):1965-70
references.pmid: 17532379
references.citation: Chest. 2013 May;143(5 Suppl):e211S-e250S
references.pmid: 23649440
references.citation: Ann Thorac Surg. 2011 Jul;92(1):226-31; discussion 231-2
references.pmid: 21718849
references.citation: J Clin Oncol. 2009 May 20;27(15):2553-62
references.pmid: 19289625
references.citation: Interact Cardiovasc Thorac Surg. 2009 Oct;9(4):618-22
references.pmid: 19602492
references.citation: Eur J Cardiothorac Surg. 2012 Jun;41(6):1342-8; discussion 1348
references.pmid: 22228841
references.citation: Ann Thorac Surg. 2013 Sep;96(3):951-60; discussion 960-1
references.pmid: 23866808
references.citation: World J Surg. 2000 Jan;24(1):27-30; discussion 30-1
references.pmid: 10594199
references.citation: Eur J Cardiothorac Surg. 2013 Aug;44(2):244-9; discussion 249
references.pmid: 23295451
references.citation: Ann Thorac Surg. 2006 Jul;82(1):214-8; discussion 219
references.pmid: 16798217
references.citation: Ann Thorac Surg. 2007 Sep;84(3):1059-65
references.pmid: 17720443
references.citation: Chest. 2011 May;139(5):1124-1129
references.pmid: 20829340
references.citation: Ann Thorac Surg. 2013 Sep;96(3):943-9; discussion 949-50
references.pmid: 23684159
references.citation: Asian Pac J Cancer Prev. 2012;13(2):447-50
references.pmid: 22524804
references.citation: Ann Thorac Surg. 2013 Mar;95(3):987-92
references.pmid: 23261117
references.citation: Jpn J Thorac Cardiovasc Surg. 1998 Jun;46(6):519-22
references.pmid: 9720370
references.citation: Ann Thorac Surg. 2010 Jun;89(6):1730-5; discussion 1736
references.pmid: 20494019
references.citation: Ann Surg. 2006 Sep;244(3):420-5
references.pmid: 16926568
references.citation: Ann Thorac Surg. 2006 Sep;82(3):1021-6
references.pmid: 16928528
references.citation: J Thorac Cardiovasc Surg. 2006 Sep;132(3):507-12
references.pmid: 16935102
references.citation: Control Clin Trials. 1996 Feb;17(1):1-12
references.pmid: 8721797
references.citation: Ann Thorac Surg. 2013 Oct;96(4):1171-1177
references.pmid: 23915591
references.citation: Ann Thorac Surg. 2001 Sep;72(3):879-84
references.pmid: 11565674
references.citation: J Clin Oncol. 2003 Mar 15;21(6):1029-34
references.pmid: 12637467
references.citation: J Thorac Cardiovasc Surg. 2009 Nov;138(5):1200-5
references.pmid: 19660381
references.citation: Ann Thorac Surg. 2007 Apr;83(4):1245-9; discussion 1250
references.pmid: 17383320
references.citation: Ann Thorac Surg. 2006 Feb;81(2):421-5; discussion 425-6
references.pmid: 16427825
references.citation: BMJ. 1997 Sep 13;315(7109):629-34
references.pmid: 9310563
references.citation: J Thorac Cardiovasc Surg. 1995 May;109(5):997-1001; discussion 1001-2
references.pmid: 7739262
references.citation: Eur J Cardiothorac Surg. 2008 May;33(5):812-8
references.pmid: 18342533
references.citation: Thorac Cardiovasc Surg. 2008 Apr;56(3):162-6
references.pmid: 18365976
references.citation: Thorac Cardiovasc Surg. 2013 Mar;61(2):116-23
references.pmid: 22411755
references.citation: Clin Lung Cancer. 2000 Aug;2(1):56-60; discussion 61
references.pmid: 14731340
references.citation: Eur J Cardiothorac Surg. 2005 May;27(5):745-52
references.pmid: 15848308
references.citation: World J Surg Oncol. 2011 Dec 21;9:170
references.pmid: 22185633
references.citation: Ann Thorac Surg. 2012 Aug;94(2):347-53; discussion 353
references.pmid: 22742843
references.citation: J Surg Oncol. 2009 Mar 15;99(4):260-4
references.pmid: 19051293
references.citation: Chest. 2009 Jul;136(1):260-271
references.pmid: 19584208