Jian-Tao Li1,2, Pei-Yao Liu3,4, Jia Huang1,2, Pei-Ji Lu1, Hao Lin1, Qian-Jun Zhou1, Qing-Quan Luo1,2. 1. Shanghai Lung Tumor Clinical Medical Center, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai 200030, China. 2. School of Medicine, Jiangsu University, Zhenjiang 212013, China. 3. Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai 200032, China. 4. Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China.
Abstract
BACKGROUND: Robotic thoracoscopic surgery was first done in mainland China in 2009 and has gained popularity in the past few years. Here, we present the largest Chinese series of robotic lobectomy for early-stage non-small cell lung cancer (NSCLC) to date. We aimed to compare the perioperative outcomes of our three-arm robotic-assisted lobectomy (RAL3) and video-assisted lobectomy (VAL) for p-stage I NSCLC and report the approach of the robotic anatomic lobar resections of our center. METHODS: We retrospectively collected and analyzed the data of 1075 stage I NSCLC patients who underwent minimally invasive lobectomies (237 RAL3 cases and 838 VAL cases) by the same surgical team from May 2013 to April 2016. Propensity score matching (PSM) was used to minimize the bias between the two groups. Perioperative outcomes were analyzed. RESULTS: Compared to the VALs, the RAL3s had more retrieved lymph nodes (LNs) (9.70 vs. 8.45, P=0.000), less POD1 drain (230.91 vs. 279.79 mL, P=0.001), shorter chest tube duration (3.84 vs. 4.33 d, P=0.003) and shorter postoperative length of stay (4.97 vs. 5.45 d, P=0.004), but a higher cost (¥93,244.84 vs. ¥67,055.82, P=0.000). No significant difference was observed between the RAL3 and VAL groups concerning the average skin-to-skin time (90.84 vs. 92.25 min, P=0.624), conversion rate (1.3% vs. 0.87%, P=1.000) and prolonged postoperative hospital stay (PPHS) rate (3.0% vs. 4.3%, P=0.694). CONCLUSIONS: This study confirms that RAL3 is a safer and more effective technique than VAL for the treatment of early-stage NSCLC.
BACKGROUND: Robotic thoracoscopic surgery was first done in mainland China in 2009 and has gained popularity in the past few years. Here, we present the largest Chinese series of robotic lobectomy for early-stage non-small cell lung cancer (NSCLC) to date. We aimed to compare the perioperative outcomes of our three-arm robotic-assisted lobectomy (RAL3) and video-assisted lobectomy (VAL) for p-stage I NSCLC and report the approach of the robotic anatomic lobar resections of our center. METHODS: We retrospectively collected and analyzed the data of 1075 stage I NSCLC patients who underwent minimally invasive lobectomies (237 RAL3 cases and 838 VAL cases) by the same surgical team from May 2013 to April 2016. Propensity score matching (PSM) was used to minimize the bias between the two groups. Perioperative outcomes were analyzed. RESULTS: Compared to the VALs, the RAL3s had more retrieved lymph nodes (LNs) (9.70 vs. 8.45, P=0.000), less POD1 drain (230.91 vs. 279.79 mL, P=0.001), shorter chest tube duration (3.84 vs. 4.33 d, P=0.003) and shorter postoperative length of stay (4.97 vs. 5.45 d, P=0.004), but a higher cost (¥93,244.84 vs. ¥67,055.82, P=0.000). No significant difference was observed between the RAL3 and VAL groups concerning the average skin-to-skin time (90.84 vs. 92.25 min, P=0.624), conversion rate (1.3% vs. 0.87%, P=1.000) and prolonged postoperative hospital stay (PPHS) rate (3.0% vs. 4.3%, P=0.694). CONCLUSIONS: This study confirms that RAL3 is a safer and more effective technique than VAL for the treatment of early-stage NSCLC.
Entities:
Keywords:
Lobectomy; non-small cell lung cancer (NSCLC); robotic; video-assisted thoracic surgery
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