BACKGROUND: This study was performed to investigate the feasibility of four-arm robotic lobectomy (FARL) as a solo surgical technique in patients with non-small cell lung cancer (NSCLC). Early outcome and long-term survival of FARL were compared with those of video-assisted thoracoscopic lobectomy (VATL). METHODS: Prospective enrollment of patients with clinical stage I NSCLC undergoing FARL or VATL (20 patients in each group) was planned. Interim analysis for early postoperative outcome was performed after the initial 10 cases in each group. RESULTS: The study was terminated early because of safety issues in the FARL group after enrollment of 12 FARL and 17 VATL patients from 2011 to 2012. There were no differences in clinical characteristics between groups. Lobectomy time and total operation time were significantly longer in the FARL group (P=0.003). There were three life-threatening events in the FARL group (2 bleedings, 1 bronchus tear) that necessitated thoracotomy conversion in 1 patient. There were no differences in other operative outcomes including pain score, complications, or length of hospital stay. Pathologic stage and number of dissected lymph nodes (LNs) were also comparable. During a follow-up of 48.9±9.5 months, recurrence was identified in 2 (16.7%) patients in FARL group and 3 (23.5%) in VATL group. Five-year overall survival (100% vs. 87.5%, P=0.386) and disease-free survival (82.5% vs. 75.6%, P=0.589) were comparable. CONCLUSIONS: FARL as solo surgery could not be recommended because of safety issues. It required a longer operation time and had no benefits over VATL in terms of early postoperative outcome or long-term survival.
BACKGROUND: This study was performed to investigate the feasibility of four-arm robotic lobectomy (FARL) as a solo surgical technique in patients with non-small cell lung cancer (NSCLC). Early outcome and long-term survival of FARL were compared with those of video-assisted thoracoscopic lobectomy (VATL). METHODS: Prospective enrollment of patients with clinical stage I NSCLC undergoing FARL or VATL (20 patients in each group) was planned. Interim analysis for early postoperative outcome was performed after the initial 10 cases in each group. RESULTS: The study was terminated early because of safety issues in the FARL group after enrollment of 12 FARL and 17 VATL patients from 2011 to 2012. There were no differences in clinical characteristics between groups. Lobectomy time and total operation time were significantly longer in the FARL group (P=0.003). There were three life-threatening events in the FARL group (2 bleedings, 1 bronchus tear) that necessitated thoracotomy conversion in 1 patient. There were no differences in other operative outcomes including pain score, complications, or length of hospital stay. Pathologic stage and number of dissected lymph nodes (LNs) were also comparable. During a follow-up of 48.9±9.5 months, recurrence was identified in 2 (16.7%) patients in FARL group and 3 (23.5%) in VATL group. Five-year overall survival (100% vs. 87.5%, P=0.386) and disease-free survival (82.5% vs. 75.6%, P=0.589) were comparable. CONCLUSIONS: FARL as solo surgery could not be recommended because of safety issues. It required a longer operation time and had no benefits over VATL in terms of early postoperative outcome or long-term survival.
Authors: Mark Meyer; Farid Gharagozloo; Barbara Tempesta; Marc Margolis; Eric Strother; Douglas Christenson Journal: Int J Med Robot Date: 2012-09-18 Impact factor: 2.547
Authors: Frank C Detterbeck; Sandra Zelman Lewis; Rebecca Diekemper; Doreen Addrizzo-Harris; W Michael Alberts Journal: Chest Date: 2013-05 Impact factor: 9.410
Authors: Johannes Bodner; Heinz Wykypiel; Andreas Greiner; Werner Kirchmayr; Martin C Freund; Raimund Margreiter; Thomas Schmid Journal: Ann Thorac Surg Date: 2004-07 Impact factor: 4.330
Authors: Giulia Veronesi; Massimo Bellomi; James L Mulshine; Giuseppe Pelosi; Paolo Scanagatta; Giovanni Paganelli; Patrick Maisonneuve; Lorenzo Preda; Francesco Leo; Raffaella Bertolotti; Piergiorgio Solli; Lorenzo Spaggiari Journal: Lung Cancer Date: 2008-03-04 Impact factor: 5.705