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. 2021 Sep 26;10(19):4408.
doi: 10.3390/jcm10194408.

Robotic Surgery for Non-Small Cell Lung Cancer Treatment in High-Risk Patients

Carmelina Cristina Zirafa  1 , Gaetano Romano  1 , Elisa Sicolo  1 , Claudia Cariello  2 , Riccardo Morganti  3 , Lucia Conoscenti  1 , Teresa Hung-Key  1 , Federico Davini  1 , Franca Melfi  1
Affiliations

Robotic Surgery for Non-Small Cell Lung Cancer Treatment in High-Risk Patients

Carmelina Cristina Zirafa et al. J Clin Med. .

Abstract

Robotic-assisted pulmonary resection has greatly increased over the last few years, yet data on the application of robotic surgery in high-risk patients are still lacking. The objective of this study is to evaluate the perioperative outcomes in ASA III-IV patients who underwent robotic-assisted lung resection for NSCLC. Between January 2010 and December 2017, we retrospectively collected the data of 148 high-risk patients who underwent lung resection for NSCLC via a robotic approach at our institution. For this study, the prediction of operative risk was based on the ASA-PS score, considering patients in ASA III and IV classes as high-risk patients: of the 148 high-risk patients identified, 146 patients were classified as ASA III (44.8%) and two as ASA IV (0.2%). Possible prognostic factors were also analysed. The average hospital stay was 6 days (8-30). Post-operative complications were observed in 87 (58.8%) patients. Patients with moderate/severe COPD developed in 33 (80.5%) cases post-operative complications, while elderly patients in 25 (55%) cases, with a greater incidence of high-grade complications. No difference was observed when comparing the data of obese and non-obese patients. Robotic surgery appears to be associated with satisfying post-operative results in ASA III-IV patients. Both marginal respiratory function and advanced age represent negative prognostic factors. Due to its safety and efficacy, robotic surgery can be considered the treatment of choice in high-risk patients.

Keywords: ASA score; high-risk patients; robotic lung surgery.

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Conflict of interest statement

F.M. and C.C.Z. are official proctors for Intuitive Surgery. The other authors have no conflict of interest to declare.

Figures

Figure 1
Figure 1
Standard port-mapping for totally endoscopic robotic lobectomy.
Figure 2
Figure 2
Overall survival of high-risk population after robotic surgery for lung cancer.
Figure 3
Figure 3
Overall survival of high-risk NSCLC patients according to tumour stage.
See this image and copyright information in PMC

References

    1. WHO The Global Cancer Observatory, “Cancer Today”—International Agency for Research on Cancer. 2020. [(accessed on 23 October 2019)]. Available online: https://gco.iarc.fr/today/data/factsheets/cancers/15-Lung-fact-sheet.pdf.
    1. WHO The Global Cancer Observatory, Estimated Age-Standardized Incidence and Mortality Rates (World) in 2020. [(accessed on 23 October 2019)]. Available online: http://gco.iarc.fr.
    1. Choi H., Mazzone P. Preoperative evaluation of the patient with lung cancer being considered for lung resection. Curr. Opin. Anaesthesiol. 2015;28:18–25. doi: 10.1097/ACO.0000000000000149. - DOI - PubMed
    1. Ruoyu Z., Jürgen D., Godehard F. Refined risk stratification for thoracoscopic lobectomy or segmentectomy. J. Thorac. Dis. 2019;11:222–230. - PMC - PubMed
    1. Chen S., Geraci T.C., Cerfolio R.J. Techniques for lung surgery: A review of robotic lobectomy. Expert Rev. Respir. Med. 2018;12:315–322. doi: 10.1080/17476348.2018.1448270. - DOI - PubMed

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