Robotic and video-assisted thoracic surgery lung segmentectomy for malignant and benign lesions

Abstract

Objectives: The experience with robotic techniques (RATS) and video-assisted thoracic surgery (VATS) in pulmonary segmentectomy is still limited. We evaluated our prospectively recorded database to compare two different minimally invasive techniques.

Methods: Between May 2007 and July 2014, a total of 99 patients underwent RATS (n = 34) and VATS (n = 65) pulmonary segmentectomies at two institutions. The median age of patients was 59 ± 15 (16-84) years, and 61% were male. Seventy-six patients were operated on for malignancy and 23 for benign diseases.

Results: The major morbidity and mortality rates were 24-23% and 0-1.5% for RATS and VATS (P = 0.57) and (P = 0.66), respectively. The mean console time for RATS was longer than the mean operation time for VATS [76 ± 23 (40-150) vs 65 ± 22 (30-120) min (P = 0.018)]. The mean duration of drainage was similar for RATS and VATS [3.53 ± 2.3 (1-10) days vs 3.98 ± 3.6 (1-21) (P = 0.90)], respectively. The duration of postoperative stay for RATS was 4.65 ± 1.94 (2-10) days and for VATS was 6.16 ± 4.7 (2-24) days (P = 0.39).

Conclusions: Both RATS and VATS pulmonary segmentectomy operations are performed with similar morbidity and mortality rates. Although the duration of operation is longer in RATS when compared with an established VATS programme, there is a tendency towards a shorter postoperative stay.

Keywords: Lung cancer; Lung resection; Robotic surgery; Segmentectomy; Video-assisted thoracic surgery.