Comparison of efficacy and safety between da Vinci robot-assisted surgery and thoracoscopic surgery in the treatment of mediastinal tumors: A systematic review and meta-analysis
Bibliographic record
Abstract
Abstract Objective Systematic evaluation of the efficacy and safety of da Vinci robot-assisted thoracic surgery (RATS) and video-assisted thoracic surgery (VATS) in the treatment of mediastinal tumors. Methods Computer retrieval of PubMed, Embase, The Cochrane Library, and Web of Science databases for literature comparing the clinical effects of RATS and VATS in treating mediastinal tumors, with the retrieval time limit from the establishment of the database to September 2023. Two researchers independently screened the literature and extracted data. The Newcastle-Ottawa Scale was used to assess the quality of the literature, and RevMan 5.4 was used for Meta-analysis. Results A total of 19 articles were included, with a total of 3517 patients. The results of the Meta-analysis showed that the RATS group had less intraoperative bleeding [MD=-5.20, 95%CI (-9.28, -1.12), P = 0.01], lower rate of conversion to thoracotomy [OR = 0.41, 95%CI (0.23, 0.72), P = 0.002], lower rate of total postoperative complications [OR = 0.57, 95%CI (0.34, 0.95), P = 0.03], shorter postoperative drainage time [MD=-0.72, 95%CI (-1.13, -0.32), P = 0.0004], and shorter postoperative hospital stay [MD=-0.90, 95%CI (-1.16, -0.65), P < 0.001], in comparison with the VATS group. There was insignificant difference between the two groups in terms of tumor size [MD=-0.02, 95%CI (-0.33, 0.30), P = 0.91] and operation time [MD = 0.17, 95%CI (-7.61, 7.94), P = 0.97]. However, in regards of hospitalization costs [MD = 2634.75, 95%CI (991.62, 4277.88), P = 0.002], the RATS group was more expensive than the VATS group. Conclusion Robot-assisted mediastinal tumor resection surgery has more advantages in terms of intraoperative bleeding, conversion to thoracotomy rate, total postoperative complication rate, postoperative drainage time, and postoperative hospital stay, in comparison with thoracoscopic-assisted mediastinal tumor resection surgery. There is insignificant difference in tumor size and operation time between the two surgeries. However, robot-assisted mediastinal tumor resection surgery increases hospitalization costs.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.012 | 0.029 |
| Meta-epidemiology (narrow) | 0.003 | 0.001 |
| Meta-epidemiology (broad) | 0.022 | 0.038 |
| Bibliometrics | 0.005 | 0.006 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".