Robotic resection of stage III lung cancer: an international retrospective study

Casiraghi, Monica; Spaggiari, Lorenzo

doi:10.21037/jtd.2018.07.90

Cited by 4 publications

(6 citation statements)

References 24 publications

(26 reference statements)

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“…However, RATS may increase the overall cost and incur a large economic burden on patients (18,20,21). As for the oncological efficacy of RATS in locally advanced NSCLC patients, several retrospective studies suggest that RATS lobectomy is safe and effective in patients with N2 disease (7)(8)(9). VATS is also a minimally invasive surgical approach that is often compared to RATS.…”

Section: Discussionmentioning

confidence: 99%

“…Other researchers found no difference in DFS or OS between RATS and thoracotomy for clinical N0 stage NSCLC patients (23), and no difference in 5-year OS across stage I-IIIA NSCLC patient treated with RATS, VATS, or thoracotomy (6). As for locally advanced NSCLC, one study discovered that minimally invasive surgical approaches (VATS and RATS) and thoracotomy displayed comparable 3-year DFS and OS (8). Consistent with reports in early-stage NSCLC patients, we discovered that c-N2 stage NSCLC patients who underwent RATS experienced a similar survival profile as those who received thoracotomy.…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies indicated that RATS reduced postoperative pain compared to thoracotomy in early-stage NSCLC patients (6). Also, several retrospective studies demonstrated that RATS was feasible for stage IIIA-N2 NSCLC, and an increase of robotic approach for stage IIIA-N2 disease from 3% in 2010 to 14% in 2016, according to analyses of the National Cancer Database (NCDB) data set, has been reported (7)(8)(9). However, to the best of our knowledge, no prospective clinical trials have been conducted to assess whether RATS is comparable to thoracotomy for cancer control in locally advanced NSCLC.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Robotic-assisted thoracic surgery reduces perioperative complications and achieves a similar long-term survival profile as posterolateral thoracotomy in clinical N2 stage non-small cell lung cancer patients: a multicenter, randomized, controlled trial

Huang¹,

Tian²,

Li³

et al. 2021

Transl Lung Cancer Res

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Background: Our previous study demonstrated the safety and short-term efficacy of robotic-assisted thoracic surgery (RATS) in clinical N2 (c-N2) stage non-small cell lung cancer (NSCLC) patients. From this, the present study was devised, in which the follow-up time and sample size were both extended to explore the long-term efficacy and potential benefit in survival of RATS compared with lobectomy in c-N2 stage NSCLC patients.Methods: Patients with c-N2 NSCLS were randomly assigned in a 1:1 ratio to accept operation through thoracotomy or RATS. The da Vinci Surgical System (Si/Xi) was applied in the RATS group, while conventional lobectomy with a rib-spreading incision was applied in the posterolateral thoracotomy group.Primary endpoint was defined as disease free survival and overall survival (OS) of all recruited patients.Results: Compared with posterolateral thoracotomy group (N=72), the RATS group (N=76) had a reduced blood loss (P<0.001), decreased drainage duration (P=0.002), and decreased postoperative pain visual analog score (all P<0.001), but increased overall cost (P<0.001). Meanwhile, no difference in the other postoperative complications (such as air leakage, subcutaneous emphysema, atrial fibrillation etc.) was found between the RATS group and the posterolateral thoracotomy group (all P>0.05). Regarding long-term outcome, no difference in disease-free survival (DFS; P=0.925) or OS (P=0.853) was observed between the RATS group and posterolateral thoracotomy group. Subgroup analyses and multivariable Cox regression analyses also found no difference in DFS or OS between the RATS group and posterolateral thoracotomy groups.Conclusions: RATS reduced intraoperative bleeding, drainage duration, postoperative pain, and achieved similar long-term survival outcomes compared with posterolateral thoracotomy in c-N2 stage NSCLC patients.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Robotic-assisted thoracic surgery reduces perioperative complications and achieves a similar long-term survival profile as posterolateral thoracotomy in clinical N2 stage non-small cell lung cancer patients: a multicenter, randomized, controlled trial

Huang¹,

Tian²,

Li³

et al. 2021

Transl Lung Cancer Res

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“…Of the neoadjuvant resections, 15% converted to thoracotomy. No conversions were for bleeding, but generally for oncologic resection due to discovery of extensive mediastinal lymph node involvement ( 13 ) ( Table 2 ).…”

Section: Post-induction Robotic Pulmonary Resectionsmentioning

confidence: 99%

Extended Robotic Pulmonary Resections

et al. 2021

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While lung cancer remains the most common cause of cancer-related mortality in the United States, surgery for curative intent continues to be a mainstay of therapy. The robotic platform for pulmonary resection for non-small cell lung cancer (NSCLC) has been utilized for more than a decade now. With respect to more localized resections, such as wedge resection or lobectomy, considerable data exist demonstrating shorter length of stay, decreased postoperative pain, improved lymph node dissection, and overall lower complication rate. There are a multitude of technical advantages the robotic approach offers, such as improved optics, natural movement of the operator's hands to control the instruments, and precise identification of tissue planes leading to a more ergonomic and safe dissection. Due to the advantages, the scope of robotic resections is expanding. In this review, we will look at the existing data on extended robotic pulmonary resections, specifically post-induction therapy resection, sleeve lobectomy, and pneumonectomy. Additionally, this review will examine the indications for these more complex resections, as well as review the data and outcomes from other institutions' experience with performing them. Lastly, we will share the strategy and outlook of our own institution with respect to these three types of extended pulmonary resections. Though some controversy remains regarding the use and safety of robotic surgery in these complex pulmonary resections, we hope to shed some light on the existing evidence and evaluate the efficacy and safety for patients with NSCLC.

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“…In view of these satisfying results, the indications for a robotic approach are being expanded, resulting today in the treatment of not only early stages of disease (28). Indeed, the improvements of the three-dimensional vision and the movements of instruments, associated with the recent introduction of the robotic staplers, enable to approach also complex cases, like locally advanced stages or following induction therapy, in a safe manner and with a rapid post-operative recovery.…”

Section: Robotic Surgery In Lung Cancermentioning

confidence: 99%

The evolution of robotic thoracic surgery

Zirafa

Romano

Key

et al. 2019

Ann. Cardiothorac. Surg.

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Robotic surgery has the features to represent the future of surgery, considering the rapid evolution of its technology and the resulting in the surgical field. In the last years, the robotic technique in thoracic surgery has progressively become widespread in the word, particularly for the treatment of the mediastinal and pulmonary lesions. The development of technology in the robotic system has been associated with the improvement of intraoperative and postoperative results. Due to the satisfying results and increasing experience and confidence with the robotic technique, surgeons are consequently enlarging the surgical indication, moving to increasingly challenging cases. Thoracic robotic surgery is being affirmed as a safe technique also for those complex cases, which in the past were considered a matter solely for open surgery. In fact, robotic surgery is increasingly associated with positive surgical results and guarantees less traumatism and a fast recovery to the patients. These positive results have resulted from the evolution of the technique, which has developed in parallel with the evolution of the technology, exploiting to its best the latest features of the robotic system. These features, such as the fluorescence-detection tool or the robotic stapler, have been aiding the surgeon to maximise the safety and feasibility of the application of the robotic technique to thoracic surgery.

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Robotic resection of stage III lung cancer: an international retrospective study

Cited by 4 publications

References 24 publications

Robotic-assisted thoracic surgery reduces perioperative complications and achieves a similar long-term survival profile as posterolateral thoracotomy in clinical N2 stage non-small cell lung cancer patients: a multicenter, randomized, controlled trial

Robotic-assisted thoracic surgery reduces perioperative complications and achieves a similar long-term survival profile as posterolateral thoracotomy in clinical N2 stage non-small cell lung cancer patients: a multicenter, randomized, controlled trial

Extended Robotic Pulmonary Resections

The evolution of robotic thoracic surgery

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