Maria F Echavarria1, Anna M Cheng1, Frank O Velez-Cubian2, Emily P Ng1, Carla C Moodie3, Joseph R Garrett3, Jacques P Fontaine4, Lary A Robinson4, Eric M Toloza5. 1. Morsani College of Medicine, University of South Florida, Tampa, FL, USA. 2. Department of Surgery, University of South Florida, Morsani College of Medicine, 12901 Bruce B Downs Blvd., Tampa, FL 33612, USA. 3. Department of Thoracic Oncology, Moffitt Cancer Center, 12902 USF Magnolia Dr., Suite FOB-1, Tampa, FL, USA. 4. Department of Surgery, University of South Florida, Morsani College of Medicine, 12901 Bruce B Downs Blvd., Tampa, FL 33612, USA; Department of Thoracic Oncology, Moffitt Cancer Center, 12902 USF Magnolia Dr., Suite FOB-1, Tampa, FL, USA; Department of Oncologic Sciences, University of South Florida, Morsani College of Medicine, 12901 Bruce B Downs Blvd., Tampa, FL 33612, USA. 5. Department of Surgery, University of South Florida, Morsani College of Medicine, 12901 Bruce B Downs Blvd., Tampa, FL 33612, USA; Department of Thoracic Oncology, Moffitt Cancer Center, 12902 USF Magnolia Dr., Suite FOB-1, Tampa, FL, USA; Department of Oncologic Sciences, University of South Florida, Morsani College of Medicine, 12901 Bruce B Downs Blvd., Tampa, FL 33612, USA. Electronic address: eric.toloza@moffitt.org.
Abstract
BACKGROUND: Lobectomy is standard treatment for early-stage lung cancer, but sublobar resection remains debated. We compared outcomes after robotic-assisted video-assisted thoracoscopic (R-VATS) segmentectomy vs lobectomy. METHODS: We retrospectively analyzed data from 251 consecutive patients who underwent R-VATS lobectomy (n = 208) or segmentectomy (n = 43) by a single surgeon over 36 months. Pulmonary function tests and perioperative outcomes were compared using Chi-squared test, unpaired Student t test, or Kruskal-Wallis test, with significance at P ≤ .05. RESULTS: Intraoperative complications were not significantly different, but median operative times were longer for R-VATS segmentectomies (P < .01). Postoperative complications were not significantly different, except for increased rates of pneumothorax after chest tube removal (P = .032) and of effusions or empyema (P = .011) after R-VATS segmentectomies. Predicted changes for forced expiratory volume in 1 second and diffusion constant of the lung for carbon monoxide are significantly less after R-VATS segmentectomy (P < .001). CONCLUSIONS: R-VATS segmentectomy should be considered as an alternative to lobectomy for conserving lung function in respiratory-compromised lung cancer patients, although oncologic efficacy remains undetermined. Copyright Â
BACKGROUND: Lobectomy is standard treatment for early-stage lung cancer, but sublobar resection remains debated. We compared outcomes after robotic-assisted video-assisted thoracoscopic (R-VATS) segmentectomy vs lobectomy. METHODS: We retrospectively analyzed data from 251 consecutive patients who underwent R-VATS lobectomy (n = 208) or segmentectomy (n = 43) by a single surgeon over 36 months. Pulmonary function tests and perioperative outcomes were compared using Chi-squared test, unpaired Student t test, or Kruskal-Wallis test, with significance at P ≤ .05. RESULTS: Intraoperative complications were not significantly different, but median operative times were longer for R-VATS segmentectomies (P < .01). Postoperative complications were not significantly different, except for increased rates of pneumothorax after chest tube removal (P = .032) and of effusions or empyema (P = .011) after R-VATS segmentectomies. Predicted changes for forced expiratory volume in 1 second and diffusion constant of the lung for carbon monoxide are significantly less after R-VATS segmentectomy (P < .001). CONCLUSIONS: R-VATS segmentectomy should be considered as an alternative to lobectomy for conserving lung function in respiratory-compromised lung cancerpatients, although oncologic efficacy remains undetermined. Copyright Â