To evaluate the efficacy and safety of video-assisted thoracoscopic surgery (VATS) versus open thoracotomy (OT) for pulmonary sequestration.

We searched the electronic databases including PubMed, Web of Science, Cochrane Library, CNKI, and Wanfang Data for relevant studies published from the establishment of the databases to May 30, 2021. Two reviewers independently screened the literature according to the inclusion and exclusion criteria, extracted data, and evaluated the quality of the literature. A meta-analysis was performed using RevMan 5.4 software.

A total of 14 retrospective cohort studies enrolling 594 patients were included, with 261 in the VATS group and 333 in the OT group. The results of meta-analysis showed that the VATS group had shorter operative time (MD=-9.48, 95%CI: -18.63 to -0.33, P=0.04), less intraoperative blood loss (MD=-60.88, 95%CI: -113.64 to -8.12, P=0.02), shorter chest drainage time (MD=-1.58, 95%CI: -2.60 to -0.56, P=0.02), lower postoperative complication rate (OR=0.54, 95%CI: 0.32-0.92, P=0.02), and shorter postoperative hospital stay (MD=-2.13, 95%CI: -3.50 to -0.77, P=0.002). There were no significant differences in the postoperative drainage volume (MD=-67.61, 95%CI: -247.93 to 112.71, P=0.46) .

VATS is a safe and feasible surgical approach in the treatment of pulmonary sequestration with advantages including shorter operative time, less intraoperative blood loss, shorter chest drainage time, lower postoperative complication rate, and shorter postoperative hospital stay.