Efficacy and safety of video-assisted thoracoscopic surgery for pulmonary TB

OBJECTIVE: Compared with thoracotomy, video-assisted thoracoscopic surgery (VATS) has the advantage of post-operative recovery for patients undergoing surgery. However, studies comparing the efficacy of VATS with conventional traditional thoracotomy for treating patients with pulmonary TB (PTB) are inconsistent. METHODS: Five electronic databases were used to search studies on VATS and conventional thoracotomy for PTB up to 15 March 2022. Standardised mean differences (SMDs) and odds ratios (ORs) were calculated for comparison. RESULTS: A total of 14 were included. Compared with traditional thoracotomy, patients with drug-resistant TB treated using VATS had shorter operative time, less intra-operative bleeding, faster post-operative recovery and fewer post-operative complications (operation time: SMD –0.87, 95% CI –1.29 to –0.45; blood loss: SMD –1.31, 95% CI –1.71 to –0.92; duration of hospital stay: SMD –1.68, 95% CI –2.46 to –0.90; catheterisation time: SMD –1.56, 95% CI –2.39 to –0.73; post-operative complication: OR 0.40, 95% CI 0.27 to 0.60). CONCLUSION: Compared with conventional thoracotomy, VATS for patients with multidrug-resistant PTB undergoing lobectomy and wedge resection has the advantages of minor bleeding, shorter operative time, shorter hospital stay and post-operative pleural cavity drainage duration, and fewer post-operative complications, which can accelerate the post-operative recovery of patients.