title: Video-assisted thoracoscopic surgery versus open thoracotomy for pulmonary metastasectomy: a systematic review.
abstract: BACKGROUND
  Pulmonary metastasectomy has become a popular procedure for patients with pulmonary metastases. It can be achieved via the traditional open thoracotomy or the more recently developed video-assisted thoracoscopic surgery (VATS). However, there has been much debate as to which approach is better in terms of detection of pulmonary metastases and, in turn, survival and recurrence outcomes. We aim to compare the two different approaches in terms of survival and recurrence outcomes.
  
  
  METHODS
  Medline and EMBASE databases were searched for relevant publications dated prior to May 2013. The bibliographies of the included articles were examined for additional relevant articles that were not included in the search. All publications reporting on overall survival and recurrence-free survival were included. The articles were carefully examined and data were extracted. STATA 12L and RevMan5.2 software were used to combine the data using the random effects model.
  
  
  RESULTS
  A total of 1960 studies were identified through the search. Thirty-two articles had extractable data regarding overall survival and recurrence-free survival. However, only eight articles were included in the end as the other 24 articles had incomplete data. From the included articles, we found that the VATS group had slightly higher odds of 1-, 3- and 5-year overall survival with odds ratios of 1.53, 1.69 and 1.41, respectively, and also higher odds of 1-, 3- and 5-year recurrence-free survival with odds ratios of 1.29, 1.54 and 1.54, respectively.
  
  
  CONCLUSIONS
  VATS offers a suitable alternative to open thoracotomy for the treatment of pulmonary metastases.
authors.affiliation: Department of Cardiothoracic Surgery, The Royal Melbourne Hospital, Melbourne, Victoria, Australia.
authors.forename: Mun Yoong
authors.initials: MY
authors.lastname: Cheang
authors.affiliation: Department of Cardiothoracic Surgery, The Royal Melbourne Hospital, Melbourne, Victoria, Australia.
authors.forename: Pradyumna
authors.initials: P
authors.lastname: Herle
authors.affiliation: Department of Cardiothoracic Surgery, The Royal Melbourne Hospital, Melbourne, Victoria, Australia.
authors.forename: Neelprada
authors.initials: N
authors.lastname: Pradhan
authors.affiliation: Department of Cardiothoracic Surgery, The Royal Melbourne Hospital, Melbourne, Victoria, Australia.
authors.forename: Phillip
authors.initials: P
authors.lastname: Antippa
mesh_terms: D018572:Disease-Free Survival; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality / Q000556:secondary* / Q000601:surgery*; D059146:Metastasectomy / Q000379:methods*; D009364:Neoplasm Recurrence, Local; D011013:Pneumonectomy / Q000379:methods*; D015996:Survival Rate; D020775:Thoracic Surgery, Video-Assisted; D013908:Thoracotomy; D016896:Treatment Outcome
keywords: VATS; open thoracotomy; overall survival; pulmonary metastasectomy; recurrence-free survival