Perioperative outcomes of robotic‐assisted versus video‐assisted thoracoscopic lobectomy: A propensity score matched analysis

Abstract

Background: The existing literature on perioperative outcomes of robotic-assisted thoracoscopic surgery (RATS) versus video-assisted thoracoscopic surgery (VATS) for lung lobectomy is inconclusive. Methods: We conducted a retrospective cohort analysis of VATS and RATS lobectomy procedures for patients with non-small cell lung cancer to compare the shortterm perioperative outcomes by propensity score matching (PSM) analysis. Results: A total of 418 patients were enrolled in this study. After PSM, 71 patients each received VATS and RATS lobectomy for further analysis. RATS lobectomy was associated with a lower rate of conversion to thoracotomy (0% vs. 5.63%, p = 0.006), a lower rate of postoperative prolonged air leak (1.14% vs. 19.72%, p = 0.001) and a shorter duration of postoperative chest tube drainage (3 days interquartile range [IQR: 3, 4] vs. 4 days IQR [3-5], p = 0.027). Subgroup analysis indicated that after acquiring proficiency in the RATS procedure, its disadvantages diminished while its advantages were enhanced. In terms of rate of conversion to thoracotomy, length of hospital stays, and duration of postoperative chest tube drainage, RATS was comparable to uniportal VATS and superior to triportal VATS. Conclusion: RATS has advantages over VATS in terms of early chest tube removal, early discharge, lower thoracotomy rate, less postoperative air leak, and a potential trend of more lymph node dissection numbers. These advantages are more pronounced after acquiring proficiency in RATS.

Subcostal uniportal robotic anatomic lung resection: A pilot trial

“…This rate appears slightly greater than that reported in previous multiport series. 21 , 22 However, neither patient required surgical intervention. Given the limited sample size in our study, it is not possible to definitively establish a correlation between the occurrence of chylothorax and SP surgery.…”