The role of VATS in the removal of intrathoracic foreign bodies — a systematic review

Introduction To date, no systematic review or meta-analysis study has been conducted regarding the use of video-assisted thoracoscopic surgery (VATS) in the removal of intrathoracic foreign bodies (FB). This systematic review aims to evaluate the feasibility of VATS in the removal of intrathoracic FBs. Methods PubMed/MEDLINE, CINAHL, Web of Science, EMBASE, and Cochrane Library databases were systematically searched to identify reports published up to April 1, 2022. Results The initial systematic search revealed a total of 208 papers, of which only 54 studies reporting 71 cases were included in this systematic review. Among the patients, 46 (64.8%) were male, 22 (31%) were female, and 3 (4.2%) were unknown. The mean age was 34.5 ± 24.3 years (1 day to 98 years). The patients were of 3 etiologic groups: iatrogenic (31, 43.7%), traumatic (28, 39.4%), and accidental (9, 12.7%). Most of the patients were emergency cases (27, 38%). The most frequently used imaging modalities to diagnose these foreign bodies were X-ray (46, 64.8%), followed by computed tomography (44, 62%), and ultrasonography (16, 22.5%). About 43% of all the foreign bodies were therapeutic equipment. The pleural cavity had the highest involvement (36.8%), followed by the lung parenchyma (14.6%) and thoracic cavity (13.2%). Regardless of the number of access ports, all the patients had a good clinical outcome. Conclusion VATS is a safe and effective method for the removal of intrathoracic FBs from various thoracic sites that are associated with a good clinical outcome — in both elective and emergency cases.