Nodal Upstaging in Robotic and Video Assisted Thoracic Surgery Lobectomy for Clinical N0 Lung Cancer

Lee, Benjamin E.; Shapiro, Mark; Rutledge, John; Korst, Robert J.

doi:10.1016/j.athoracsur.2015.03.109

Cited by 59 publications

(64 citation statements)

References 8 publications

(19 reference statements)

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“…The rate of upward N stage migration in this series was 10.8%, which is slightly lower than published rates of RATS nodal upstaging of 13.2%. 15 Our rates were comparable to reported ranges of VATS nodal upstaging, reported to be 8.1%-15.2%, [15][16][17] and thoracotomy, report ed to be 11.5%-13.1%. 17 This series provides comparable results to the robotic literature and confirms the safety of robotic resection for pulmonary lobectomy.…”

Section: Discussionsupporting

confidence: 73%

Robotic-assisted thoracoscopic surgery for lung resection: the first Canadian series

Fahim

Hanna

Waddell

et al. 2017

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Background: Robotic surgery was introduced as a platform for minimally invasive lung resection in Canada in October 2011. We present the first Canadian series of robotic pulmonary resection for lung cancer.Methods: Prospective databases at 2 institutions were queried for patients who underwent robotic resection for lung cancer between October 2011 and June 2015.To examine the effect of learning curves on patient and process outcomes, data were organized into 3 temporal tertiles, stratified by surgeon.Results: A total of 167 consecutive patients were included in the study. Median age was 66 (range 27-88) years, and 46.1% (n = 77) of patients were men. The majority of patients (n = 141, 84%) underwent robotic lobectomy. Median duration of surgery was 270 (interquartile range [IQR] 233-326) minutes, and median length of stay (LOS) was 4 (IQR 3-6) days. Twelve patients (7%) were converted to thoracotomy. Total duration of surgery and console time decreased significantly (p < 0.001) across tertiles, with a steady decline until case 20, followed by a plateau effect. Across tertiles, there was no significant difference in LOS, number of lymph node stations removed, or perioperative complications. Conclusion:The results of this case series are comparable to those reported in the literature. A prospective study to examine the outcomes and cost of robotic pulmonary resection compared with video-assisted thoracoscopic surgery should be done in the context of the Canadian health care system. We have presented the first consecutive case series of robotic lobectomy in Canada. Outcomes compare favourably to other series in the literature.Contexte : C'est en octobre 2011 que la chirurgie robotisée a fait son entrée au Cana da comme approche à la résection pulmonaire minimalement effractive. Nous présentons à notre connaissance la première série canadienne sur la résection pulmonaire robotisée pour le cancer du poumon.Méthodes : Nous avons interrogé les bases de données prospectives de 2 établissements pour recenser les patients ayant subi une résection robotisée pour un cancer du poumon entre octobre 2011 et juin 2015. Nous avons organisé les données en 3 tertiles temporels et nous les avons stratifiées par chirurgien pour mesurer l'effet des courbes d'apprentissage sur les résultats enregistrés chez les patients et du point de vue des procédés.Résultats : En tout, 167 patients consécutifs ont été inclus dans l'étude. L'âge médian était de 66 ans (entre 27 et 88 ans) et 46,1 % (n = 77) étaient des hommes. La majorité des patients (n = 141, 84 %) ont subi une lobectomie robotisée. La durée moyenne des interventions a été de 270 minutes (intervalle interquartile [IIQ] 96) et la durée mé diane des séjours a été de 4 jours (IIQ 3). L'intervention s'est transformée en thoracotomie chez 12 patients (7 %). La durée totale de la chirurgie et le temps passé à la console ont diminué significativement (p < 0,001) selon les différents tertiles, avec un déclin constant jusqu'au cas no 20, suivi d'un effet de plateau. Entre les tertiles, on...

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Section: Discussionsupporting

confidence: 73%

Robotic-assisted thoracoscopic surgery for lung resection: the first Canadian series

Fahim

Hanna

Waddell

et al. 2017

cjs

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“…Pooled results of 13 studies demonstrated a mean operative time of 190.08 min (range: 100-241 min) [22][23][24][25][26][27][28][29][30][31] . All but one study 25 determined this to be significantly longer than VATS or thoracotomy 32 (Table 2).…”

Section: Operative Timementioning

confidence: 97%

“…Eleven studies [17][18][19]23,[26][27][28][29][33][34] included in the pooled analysis demonstrated a mean conversion rate of 7.90% (121/1531). Series with larger cohorts reported more consistent rates of conversion [27][28][29] .…”

Section: Conversion To Thoracotomymentioning

confidence: 98%

The Use of Robotic-Assisted Thoracic Surgery for Lung Resection: A Comprehensive Systematic Review

Agzarian

Fahim

Shargall

et al. 2016

Seminars in Thoracic and Cardiovascular Surgery

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“…Our data suggest that the ability to perform lymphadenectomy is similar between robotic and VATS cases in respect of both resected number of lymph nodes and lymph stations. Previous studies comparing mediastinal lymphadenectomy have demonstrated both equivalence between the two minimally invasive approaches (16) or favoring robotic approach because of higher upstaging rate (17). Although robotic technique is similar to traditional open thoracotomy which would be theoretically better for lymph node dissection, this lack of difference may reflect the most important determinant of lymph node dissection is whether the surgeon is dedicated to lymph node harvesting and systematic evaluation regardless of the technique (10,16).…”

Section: Discussionmentioning

confidence: 89%

Comparison of robotic and video-assisted thoracic surgery for lung cancer: a propensity-matched analysis

Bao¹,

Zhang²,

Yang³

et al. 2016

J. Thorac. Dis.

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Background: Reports of comparison between robotic and thoracoscopic surgery for lung cancer are limited, we aimed to compare the perioperative outcomes of robotic and thoracoscopic anatomic pulmonary resection for lung cancer. 50.3±37.9 mL, P=0.531), morbidity rates (42.0% vs. 30.4%, P=0.157) were similar between the robotics and thoracoscopy. However, robotics was associated with higher cost ($12,067±1,610 vs. $8,328±1,004, P<0.001), and longer operative time (136±40 vs. 111±28 min, P<0.001). Conclusions: Robotics seems to have higher hospital costs and longer operative time, without superior advantages in morbidity rates and oncologic efficiency. Further prospective randomized clinical trials were needed to validate both of its short-and long-term oncologic efficiency.

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Nodal Upstaging in Robotic and Video Assisted Thoracic Surgery Lobectomy for Clinical N0 Lung Cancer

Cited by 59 publications

References 8 publications

Robotic-assisted thoracoscopic surgery for lung resection: the first Canadian series

Robotic-assisted thoracoscopic surgery for lung resection: the first Canadian series

The Use of Robotic-Assisted Thoracic Surgery for Lung Resection: A Comprehensive Systematic Review

Comparison of robotic and video-assisted thoracic surgery for lung cancer: a propensity-matched analysis

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