Clinical efficacy and safety of different video-assisted thoracoscopic surgery approaches for bullous lung resection: a systematic review and meta-analysis

By
Ting Gao
Xiaopeng He
Peiwen Zhao
May 29, 2026
0 min

Frontiers In Surgery

Overview

This meta-analysis evaluates the perioperative safety and effectiveness of single-port versus multi-port video-assisted thoracoscopic surgery (VATS) for bullous lung resection. Findings indicate that single-port VATS leads to shorter hospital stays, reduced postoperative pain, and lower incidence of chest wall paresthesia without increasing operative time or complication rates.

Background

Primary spontaneous pneumothorax (PSP) is a common thoracic condition, particularly in males, characterized by the rupture of lung bullae. Surgical intervention is often required to prevent recurrence, as conservative management has high failure rates. Video-assisted thoracoscopic surgery (VATS) has emerged as a less invasive alternative to traditional open thoracotomy, but the comparative advantages of single-port versus multi-port techniques remain under investigation.

Data Highlights

{'MD': 'Mean Difference', 'RR': 'Risk Ratio'}

Key Findings

Single-port VATS significantly reduces hospital stay compared to multi-port VATS.
Postoperative pain is lower in patients undergoing single-port VATS.
The incidence of chest wall paresthesia is reduced with single-port VATS.
No significant differences in operative time, chest tube duration, or complication rates were observed between the two techniques.
Conventional single-port techniques primarily drive the reduction in hospital stay.

Clinical Implications

Single-port VATS may offer a safer and more effective option for bullous lung resection, leading to quicker recovery and less postoperative discomfort. Clinicians should consider this approach, especially for patients at risk of prolonged hospital stays or significant postoperative pain.

Conclusion

Single-port VATS represents a viable alternative to multi-port techniques for bullous lung resection, providing benefits in recovery and pain management without compromising safety. Further randomized trials are warranted to confirm these findings.