Ten Years' Experience in Robotic-Assisted Thoracic Surgery for Early Stage Lung Cancer

Casiraghi, Monica; Galetta, Domenico; Borri, Alessandro; Tessitore, Adele; Romano, Rosalia; Diotti, Cristina; Brambilla, Daniela; Maisonneuve, Patrick; Spaggiari, Lorenzo

doi:10.1055/s-0038-1639575

Cited by 26 publications

(33 citation statements)

References 29 publications

(45 reference statements)

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“…Also in our recent series of 339 patients who underwent RATS for clinical stages I-II NSCLC, we showed an excellent overall lymph node upstaging (17.6%) and 58% of 5-year stage specific survival for occult pN2 patients (n=28) confirming that mediastinal lymph node dissection during RATS adequately assesses lymph node stations leading to excellent oncologic results (19).…”

supporting

confidence: 58%

“…However, the most common indication for minimally invasive approach in lung cancers with either VATS or RATS, are early stage non-small cell lung cancer (NSCLC) (stage I and II) (19). Despite some series report the use of robotic surgery in patients with both initial or locally advanced NSCLC (8)(9)(10)(11)(12)(13), the results of this approach specifically for stage III disease have been described only in very limited retrospective studies (11,(20)(21)(22)(23)(24), showing anyhow similar oncological outcomes between open and minimally invasive groups, in term of post-operative outcome and survival even after chemotherapy.…”

mentioning

confidence: 99%

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

Casiraghi¹,

Spaggiari²

2018

J. Thorac. Dis.

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supporting

confidence: 58%

mentioning

confidence: 99%

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

Casiraghi¹,

Spaggiari²

2018

J. Thorac. Dis.

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“…In fact, this finding is similar to that reported by other investigators. 5 - 7 , 13 Air leak prolongs the length of hospital stay, increases the chance of pleural infection, and often leads to additional procedures such as chest tube insertion. In our study, 4 patients (2.5%) required extended pleural drainage.…”

Section: Discussionmentioning

confidence: 99%

“…The rate of complete resection in the present study (97.4%) is also consistent with data in the literature. 13 , 17 …”

Section: Discussionmentioning

confidence: 99%

Robotic thoracic surgery for non-small cell lung cancer: initial experience in Brazil

et al. 2020

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Objective: To describe the morbidity, mortality, and rate of complete resection associated with robotic surgery for the treatment of non-small cell lung cancer in Brazil, as well as to report the rates of overall survival and disease-free survival in patients so treated. Methods: This was a retrospective study of patients diagnosed with non-small cell lung carcinoma and undergoing resection by robotic surgery at one of six hospitals in Brazil between February of 2015 and July of 2018. Data were collected retrospectively from the electronic medical records. Results: A total of 154 patients were included. The mean age was 65 ± 9.5 years (range, 30-85 years). The main histological diagnosis was adenocarcinoma, which was identified in 128 patients (81.5%), followed by epidermoid carcinoma, identified in 14 (9.0%). Lobectomy was performed in 133 patients (86.3%), and segmentectomy was performed in 21 (13.7%). The mean operative time was 209 ± 80 min. Postoperative complications occurred in 32 patients (20.4%). The main complication was air leak, which occurred in 15 patients (9.5%). The median (interquartile range) values for hospital stay and drainage time were 4 days (3-6 days) and 2 days (2-4 days), respectively. There was one death in the immediate postoperative period (30-day mortality rate, 0.5%). The mean follow-up period was 326 ± 274 days (range, 3-1,110 days). Complete resection was achieved in 97.4% of the cases. Overall mortality was 1.5% (3 deaths), and overall survival was 97.5%. Conclusions: Robotic pulmonary resection proved to be a safe treatment for lung cancer. Longer follow-up periods are required in order to assess long-term survival.

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“…Most of the cases where in clinical stage I and II. Limitations of this study are the retrospective data analysis and single center nature(30). The ongoing ROMAN study will further evaluate the differences in terms of conversion-to-open and postoperative complication rate between RATS and VATS, either lobectomy or segmentectomy…”

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confidence: 99%

Overview of the outcomes of robotic segmentectomy and lobectomy

Veronesi¹,

Novellis²,

Perroni³

2021

J Thorac Dis

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Segmentectomy has gained popularity in the latest years as a valid alternative to lobectomy.Initially reserved to patient unfit for lobar lung resection, this procedure is now offered also in selected patient with <2 cm peripheral lung cancer confined to an anatomic segment with no nodal involvement on preoperative evaluation. The introduction of screening with low-dose CT chest scan allowed the identification of lung cancer at early stages, making possible to schedule a more conservative lung surgery.A major improvement came also from minimally invasive surgery (MIS), reducing complication rate with comparable survival rates when compared to open surgery. However, due to long learning curve and uncomfortable instruments handling of video-assisted thoracoscopy, many surgeons still prefer to perform segmentectomies through a thoracotomy and thus increasing perioperative morbidity and leading to postthoracotomy syndrome due to rib-spreading. Robotic assisted thoracic surgery (RATS) can avoid this throwback, combining the handling of open surgery with lesser invasiveness of thoracoscopy. Although literature has given strong evidences in favour of robotic lobectomies, data are still limited regarding segmentectomies performed with this technique. Moreover, no results are still available from the two ongoing randomized controlled trials comparing segmentectomy to lobectomy and so the latter represent the oncologically proper procedure for lung cancer along with lymph-node dissection. In this review we analyse the literature currently available on outcomes of lobar and sublobar anatomical resection performed by RATS, with a brief mention of the existing surgical techniques of port positioning and the costs of this procedure.

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Ten Years' Experience in Robotic-Assisted Thoracic Surgery for Early Stage Lung Cancer

Cited by 26 publications

References 29 publications

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

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

Robotic thoracic surgery for non-small cell lung cancer: initial experience in Brazil

Overview of the outcomes of robotic segmentectomy and lobectomy

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