中文摘要：

目的分析对比胸腔镜手术（video—assistedthoracicsurgery，VATS）与开胸手术在临床I期肺癌淋巴结清扫上的效果差异。方法按照Cochrane系统评价制作方法，通过PubMed、OvidMedline、Embase、WebofScience、ScienceDirect、theCochraneLibrary、Scopus数据库及GoogleScholar搜索VATS和开胸手术治疗临床I期肺癌的对比研究，运用RevMan5．3软件分析两组间淋巴结清扫相关数据。结果经过筛选，纳入23篇文献，共5662例患者，其中VATS组2316例，开胸手术组3346例。Meta分析结果显示，VATS组总淋巴结清扫数（95％CI：-1．64～-0．60，P〈0．0001）、总淋巴结清扫站数（95％CI：0．61～-0．01，P=0．04）及N1淋巴结清扫数（95％CI：0．28～-0．02，P=0．02）少于开胸手术组，但左侧淋巴结清扫数多于开胸手术组（95％CI：0．51～3．22，P=0．007）。两组N2淋巴结清扫数（95％CI：0．74～0．15，P=0．20）、N2淋巴结清扫站数（95％CI：0．20-0．14，P=0．76）、右侧淋巴结清扫数（95％CI：～1．52—2．23，P=0．71）差异均无统计学意义。结论在临床I期肺癌手术治疗中，VATS手术总淋巴结清扫数、总淋巴结清扫站数及N1淋巴结清扫数少于开放手术，但更适合左侧淋巴结清扫，右侧淋巴结清扫能够达到与传统开胸手术类似的效果，上述结果仍需更多高质量大样本随机对照研究进行验证。

英文摘要：

Objective To compare the efficacy of lymph nodes（LNs） dissection between video-assisted thoracic surgery （VATS） and thoracotomy in the treatment of clinical stage I lung cancer. Methods A comprehensive search of PubMed, Ovid Medline, EMBASE, Web of Science, ScienceDirect, the Cochrane Library, Scopus database and Google Scholar was per- formed to identify studies comparing VATS and thoracotomy in LNs dissection. The data was analyzed by RevMan 5.3 software and SPSS 18.0. Results After selection, 23 articles met the inclusion criteria. 2 316 patients were involved in VATS group and 3 346 patients were involved in Open group. Meta analysis showed that less total LNs （95% CI： - 1.64 - -O. 60, P 〈 0.0001）, totalLNsstations（95%Cl： -0.61- -0.01, P= 0.04） and N1 LNs（95%CI： -0.28- -0.02, P= 0.02） were dissected in VATS group. On the left side, more LNs were dissected in VATS group（95% CI： O. 51 - 3.22, P = 0. 007）. The same number of mediastinal LNs （ 95% CI： - 0.74 - 0. 15, P = 0.20 ） , mediastinal LNs stations （95% CI： - 0.20 - 0.14, P = 0.76 ）, right side LNs （95 % CI： - 1.52 - 2.23, P = 0.71 ） were harvested in both groups. Conclusion In the surgical treatment of clinical stage [ lung cancer, less total LNs, total LNs stations and N1 LNs were dissected in VATS group, while more left side LNs were harvested by VATS. The same number of mediastinal LNs, mediastinal LNs sta- tions right side LNs were harvested in the two groups. This conclusion still needs to be further proved by more high-quality and large-scale RCTs.