Michael S Kent1, Matthew G Hartwig, Eric Vallières, Abbas E Abbas, Robert J Cerfolio, Mark R Dylewski, Thomas Fabian, Luis J Herrera, Kimble G Jett, Richard S Lazzaro, Bryan Meyers, Brian A Mitzman, Rishindra M Reddy, Michael F Reed, David C Rice, Patrick Ross, Inderpal S Sarkaria, Lana Y Schumacher, William B Tisol, Dennis A Wigle, Michael Zervos. 1. Division of Thoracic Surgery, and Interventional Pulmonology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston MA Division of Thoracic Surgery, Duke University, Durham, NC Division of Thoracic Surgery, Swedish Cancer Institute, Seattle, WA Division of Thoracic Surgery, Temple University Health System, Philadelphia, PA Division of Thoracic Surgery, NYU Langone, New York, NY General Thoracic Surgery, Baptist Health Medical Group, South Miami, FL Division of Thoracic Surgery, Albany Medical Center, Albany, NY Rod Taylor Thoracic Care Center, Orlando Health UF Health Cancer Center, Orlando FL Division of Thoracic Surgery, Baylor Scott & White The Heart Hospital - Plano, Plano, TX Department of Cardiothoracic Surgery, Northwell Health, New York, NY Department of Surgery, Washington University School of Medicine in St. Louis, St. Louis, MO Division of Thoracic Surgery, NYU Winthrop, Mineola, NY Division of Thoracic Surgery, University of Michigan Medical Center, Ann Arbor, MI Division of Thoracic Surgery, Penn State Cancer Institute, Hershey, PA Department of Thoracic and Cardiovascular Surgery, The University of Texas M.D. Anderson Cancer Main Line Health Care Thoracic Surgery, Main Line Health, Wynewood, PA Department of Cardiothoracic Surgery, Division of Thoracic Surgery, UPMC, Pittsburgh, PA Division of Thoracic Surgery, Massachusetts General Hospital, Boston, MA Division of Thoracic Surgery, Aurora Health Care, Grafton, MI Division of General Thoracic Surgery, Mayo Clinic, Rochester, MN.
Abstract
OBJECTIVE: The aim of this study was to analyze outcomes of open lobectomy (OL), video-assisted thoracoscopic lobectomy (VATS) and robotic-assisted lobectomy (RL). SUMMARY BACKGROUND DATA: Robotic-assisted lobectomy has seen increasing adoption for treatment of early-stage lung cancer. Comparative data regarding these approaches is largely from single-institution case series or administrative datasets. METHODS: Retrospective data was collected from 21 institutions from 2013-2019. All consecutive cases performed for clinical stage IA-IIIA lung cancer were included. Neoadjuvant cases were excluded. Propensity-score matching (1:1) was based on age, gender, race, smoking-status, FEV1%, Zubrod score, ASA score, tumor size and clinical T and N stage. RESULTS: A total of 2,391 RL, 2,174 VATS, and 1,156 OL cases were included. After propensity-score matching there were 885 pairs of RL vs. OL, 1,711 pairs of RL vs. VATS, and 952 pairs of VATS vs. OL. Operative time for RL was shorter than VATS (p < 0.0001) and OL (p = 0.0004). Compared to OL, RL and VATS had less overall postoperative complications, shorter hospital stay (LOS), and lower transfusion rates (all p < 0.02). Compared to VATS, RL had lower conversion rate (p < 0.0001), shorter hospital stay (p < 0.0001) and a lower postoperative transfusion rate (p = 0.01). RL and VATS cohorts had comparable postoperative complication rates. In-hospital mortality was comparable between all groups. CONCLUSIONS: RL and VATS approaches were associated with favorable perioperative outcomes compared to OL. Robotic-assisted lobectomy was also associated with a reduced length of stay and decreased conversion rate when compared to VATS.
OBJECTIVE: The aim of this study was to analyze outcomes of open lobectomy (OL), video-assisted thoracoscopic lobectomy (VATS) and robotic-assisted lobectomy (RL). SUMMARY BACKGROUND DATA: Robotic-assisted lobectomy has seen increasing adoption for treatment of early-stage lung cancer. Comparative data regarding these approaches is largely from single-institution case series or administrative datasets. METHODS: Retrospective data was collected from 21 institutions from 2013-2019. All consecutive cases performed for clinical stage IA-IIIA lung cancer were included. Neoadjuvant cases were excluded. Propensity-score matching (1:1) was based on age, gender, race, smoking-status, FEV1%, Zubrod score, ASA score, tumor size and clinical T and N stage. RESULTS: A total of 2,391 RL, 2,174 VATS, and 1,156 OL cases were included. After propensity-score matching there were 885 pairs of RL vs. OL, 1,711 pairs of RL vs. VATS, and 952 pairs of VATS vs. OL. Operative time for RL was shorter than VATS (p < 0.0001) and OL (p = 0.0004). Compared to OL, RL and VATS had less overall postoperative complications, shorter hospital stay (LOS), and lower transfusion rates (all p < 0.02). Compared to VATS, RL had lower conversion rate (p < 0.0001), shorter hospital stay (p < 0.0001) and a lower postoperative transfusion rate (p = 0.01). RL and VATS cohorts had comparable postoperative complication rates. In-hospital mortality was comparable between all groups. CONCLUSIONS: RL and VATS approaches were associated with favorable perioperative outcomes compared to OL. Robotic-assisted lobectomy was also associated with a reduced length of stay and decreased conversion rate when compared to VATS.
Authors: Paresh C Shah; Alexander de Groot; Robert Cerfolio; William C Huang; Kathy Huang; Chao Song; Yanli Li; Usha Kreaden; Daniel S Oh Journal: Surg Endosc Date: 2022-02-09 Impact factor: 3.453
Authors: Jia Huang; Yu Tian; Qian-Jun Zhou; Jun-Wei Ning; Ze-Nan Gu; Pei-Ji Lu; Jian-Tao Li; Hao Lin; Tian-Xiang Chen; Yun-Hai Yang; Min P Kim; Robert E Merritt; Marco Ghisalberti; Long Jiang; Qing-Quan Luo Journal: Transl Lung Cancer Res Date: 2021-12