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. 2019 Dec;8(6):820-828.
doi: 10.21037/tlcr.2019.10.15.

Comparison of robotic-assisted lobectomy with video-assisted thoracic surgery for stage IIB-IIIA non-small cell lung cancer

Chongwu Li  1 , Yingjie Hu  1 , Jia Huang  1 , Jiantao Li  1 , Long Jiang  1 , Hao Lin  1 , Peiji Lu  1 , Qingquan Luo  1
Affiliations

Comparison of robotic-assisted lobectomy with video-assisted thoracic surgery for stage IIB-IIIA non-small cell lung cancer

Chongwu Li et al. Transl Lung Cancer Res. 2019 Dec.

Abstract

Background: With the rapid development of surgical technics and instruments, more and more locally advanced non-small cell lung cancer (NSCLC) patients are being treated by minimally invasive surgery (MIS), including video-assisted thoracoscopic surgery (VATS) and robotic-assisted thoracic surgery (RATS). The aim of this retrospective study was to compare the perioperative and long-term outcomes of patients who underwent lobectomy by these two surgical approaches.

Methods: We performed a retrospective review of the prospectively collected database of our hospital to identify patients with clinical stage IIB-IIIA NSCLC who underwent video-assisted thoracoscopic or robotic lobectomy. Perioperative outcomes, recurrence, and overall survival (OS) were compared.

Results: From January 2014 to January 2017, there were at total of 121 patients, including 36 robotic lobectomy patients and 85 VATS lobectomy patients. One patient (2.8%) in the RATS group and 5 patients (5.9%) in the VATS group were converted to thoracotomy (P=0.79). No perioperative death was observed in both groups. The postoperative morbidity was similar between the two groups (13.9% for RATS vs. 15.3% for VATS; P=0.84). Robotic lobectomy was associated with a shorter length of postoperative hospital stay (4 vs. 5 d, P<0.01) and more counts of lymph nodes harvested (13 vs. 10, P<0.01). The median disease-free survival (DFS) for the RATS and VATS groups were 31.1 and 33.8 months, respectively. The corresponding 3-year DFS was 40.3% in the RATS group and 47.6% in the VATS group (P=0.74). The 3-year OS was 75.7% in RATS and 77.0% in the VATS group (P=0.75).

Conclusions: For selected NSCLC patients with lymph node involvement, robotic lobectomy is safe and effective with a low complication rate and similar long-term outcome compared with VATS lobectomy. Moreover, the robotic approach resulted in shorter postoperative length of stay and greater lymph node assessment.

Keywords: Lung cancer; lobectomy; minimally invasive surgery (MIS); robotic surgery.

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Conflict of interest statement

Conflicts of Interest: The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
OS between the RATS and VATS group (P=0.75). RATS, robotic-assisted thoracic surgery; VATS, video-assisted thoracoscopic surgery; OS, overall survival.
Figure 2
Figure 2
DFS between the RATS and VATS group (P=0.74). RATS, robotic-assisted thoracic surgery; VATS, video-assisted thoracoscopic surgery; DFS, disease-free survival.
See this image and copyright information in PMC

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