Abstract: Objective · To compare the efficacy of video-assisted thoracic surgery (VATS) and conventional lung volume reduction surgery for the treatment of patients with severe chronic obstructive pulmonary disease with a meta-analysis.  Methods ·  Randomized controlled trials (RCT) and nonrandomized control studies of VATS (the VATS group) and conventional lung volume reduction surgery (the thoracotomy group) for treating patients with severe chronic obstructive pulmonary disease were collected from databases, including Web of Science, EMbase, PubMed, the Cochrane Library, CNKI, CBM disc, WanFang Data, and VIP. The latest literature was published in November 2016. The assessment included the quality of literature and RevMan5.3 software was used to perform the meta-analysis.  Results · Of 779 retrieved articles, 12 studies involving 966 patients were included according to the inclusion criteria. The results of meta-analysis showed that the operation time of bilateral LVRS was longer in the VATS group than in the thoracotomy group, but the difference in the operation time of single LVRS between the two groups was not statistically significant. The difference in the duration of chest tube drainage for bilateral LVRS between the two groups was not statistically significant, while the duration of chest tube drainage for single LVRS was significantly shorter in the VATS group than in the thoracotomy group. The amount of intraoperative blood loss postoperative drainage was significantly smaller in the VATS group than in the thoracotomy group. Postoperative pulmonary function and blood gas analysis showed that the 6 min walking distance was longer in the VATS group than in the thoracotomy group. The differences in FEV1 and PaO2 between the two groups were not statistically significant, as well as the difference in postoperative complications between the two groups.  Conclusion · Comparing to conventional lung volume reduction surgery, Video-Assisted thoracic lung volume reduction surgery is a better choice. However, randomized control trials with higher quality and larger scale are required for verification this conclusion due to limitations of the quality and samples of these studies.

Key words: lung volume reduction, chronic obstructive pulmonary disease, video-assisted thoracic surgery, meta-analysis, randomized controlled trials