Background: The aim of this study was to investigate which surgical method is better in lymph node (LN)\ndissection of lung cancer.\nMethods: A comprehensive search of PubMed, Ovid MEDLINE, EMBASE, Web of Science, ScienceDirect, the\nCochrane Library, Scopus, and Google Scholar was performed to identify studies comparing thoracoscopic\nlobectomy (video-assisted thoracic surgery (VATS) group) and thoracotomy (open group) in LN dissection.\nResults: Twenty-nine articles met the inclusion criteria and involved 2763 patients in the VATS group and 3484\npatients in the open group. The meta-analysis showed that fewer total LNs (95% confidence interval [CI] âË?â??1.52 to\nâË?â??0.73, p < 0.0001) and N2 LNs (95% CI âË?â??1.25 to âË?â??0.10, p = 0.02) were dissected in the VATS group. A similar number\nof total LN stations, N2 LN stations, and N1 LNs were harvested in both groups. Only one study reported that fewer\nN1 LN stations were dissected in the VATS group (1.4 Ã?± 0.5 vs. 1.6 Ã?± 0.6, p = 0.04).\nConclusions: Open lobectomy could achieve better LN dissection efficacy than thoracoscopic lobectomy in the\ntreatment of lung cancer, especially in the N2 LNs dissection. These findings require validation by high-quality,\nlarge-scale randomized controlled trials.
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