Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Apr 21;15(8):2391.
doi: 10.3390/cancers15082391.

Robotic versus Video-Assisted Thoracic Surgery for Lung Cancer: Short-Term Outcomes of a Propensity Matched Analysis

Savvas Lampridis  1 , Alessandro Maraschi  1 , Corinne Le Reun  2 , Tom Routledge  1 , Andrea Billè  1
Affiliations

Robotic versus Video-Assisted Thoracic Surgery for Lung Cancer: Short-Term Outcomes of a Propensity Matched Analysis

Savvas Lampridis et al. Cancers (Basel). .

Abstract

Robot-assisted thoracic surgery (RATS) has gained popularity for the treatment of lung cancer, but its quality outcome measures are still being evaluated. The purpose of this study was to compare the perioperative outcomes of lung cancer resection using RATS versus video-assisted thoracic surgery (VATS). To achieve this aim, we conducted a retrospective analysis of consecutive patients who underwent lung cancer surgery between July 2015 and December 2020. A propensity-matched analysis was performed based on patients' performance status, forced expiratory volume in 1 s% of predicted, diffusing capacity of the lungs for carbon monoxide% of predicted, and surgical procedure (lobectomy or segmentectomy). Following propensity matching, a total of 613 patients were included in the analysis, of which 328 underwent RATS, and 285 underwent VATS, with satisfactory performance indicators. The results of the analysis indicated that RATS had a significantly longer operating time than VATS (132.4 ± 37.3 versus 122.4 ± 27.7 min; mean difference of 10 min 95% CI [confidence interval], 4.2 to 15.9 min; p = 0.001). On the other hand, VATS had a significantly higher estimated blood loss compared to RATS (169.7 ± 237.2 versus 82.2 ± 195.4 mL; mean difference of 87.5 mL; 95% CI, 48.1 to 126.8 mL; p < 0.001). However, there were no significant differences between the groups in terms of the duration of chest tubes, length of hospital stay, low- and high-grade complications, as well as readmissions and mortality within 30 days after surgery. Moreover, the number of dissected lymph-node stations was significantly higher with VATS than RATS (5.9 ± 1.5 versus 4.8 ± 2.2; mean difference of 1.2; 95% CI, 0.8 to 1.5; p = 0.001). Nonetheless, the percentage of patients who were upstaged after histopathological analysis of the resected lymph nodes was similar between the two groups. In conclusion, RATS and VATS yielded comparable results for most of the short-term outcomes assessed. Further research is needed to validate the implementation of RATS and identify its potential benefits over VATS.

Keywords: lobectomy; lung cancer; minimally invasive surgery; robotic surgery; segmentectomy; video-assisted thoracic surgery (VATS).

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results.

References

    1. Thai A.A., Solomon B.J., Sequist L.V., Gainor J.F., Heist R.S. Lung cancer. Lancet. 2021;398:535–554. doi: 10.1016/S0140-6736(21)00312-3. - DOI - PubMed
    1. Kirby T.J., Mack M.J., Landreneau R.J., Rice T.W. Lobectomy—Video-assisted thoracic surgery versus muscle-sparing thoracotomy: A randomized trial. J. Thorac. Cardiovasc. Surg. 1995;109:997–1002. doi: 10.1016/S0022-5223(95)70326-8. - DOI - PubMed
    1. Paul S., Altorki N.K., Sheng S., Lee P.C., Harpole D.H., Onaitis M.W., Stiles B.M., Port J.L., D’Amico T.A. Thoracoscopic lobectomy is associated with lower morbidity than open lobectomy: A propensity-matched analysis from the STS database. J. Thorac. Cardiovasc. Surg. 2010;139:366–378. doi: 10.1016/j.jtcvs.2009.08.026. - DOI - PubMed
    1. Bendixen M., Jørgensen O.D., Kronborg C., Andersen C., Licht P.B. Postoperative pain and quality of life after lobectomy via video-assisted thoracoscopic surgery or anterolateral thoracotomy for early stage lung cancer: A randomised controlled trial. Lancet Oncol. 2016;17:836–844. doi: 10.1016/S1470-2045(16)00173-X. - DOI - PubMed
    1. Demmy T.L., Yendamuri S., D’amico T.A., Burfeind W.R. Oncologic Equivalence of Minimally Invasive Lobectomy: The Scientific and Practical Arguments. Ann. Thorac. Surg. 2018;106:609–617. doi: 10.1016/j.athoracsur.2018.02.089. - DOI - PubMed

LinkOut - more resources