title: Robot-Assisted Thoracoscopic Surgery versus Video-Assisted Thoracoscopic Surgery for Lung Lobectomy: Can a Robotic Approach Improve Short-Term Outcomes and Operative Safety?
abstract: Background Minimally invasive surgery has been recently recommended for treatment of early-stage non-small cell lung cancer. Despite the recent increase of robotic surgery, the place and potential advantages of the robot in thoracic surgery has not been well defined until now. Methods We reviewed our prospective database for retrospective comparison of our first 28 video-assisted thoracoscopic surgery lobectomies (V group) and our first 28 robotic lobectomies (R group). Results No significant difference was shown in median operative time between the two groups (185 vs. 190 minutes, p = 0.56). Median preincision time was significantly longer in the R group (80 vs. 60 minutes, P < 0.0001). The rate of emergency conversion for uncontrolled bleeding was lower in the R group (one vs. four). Median length of stay was comparable (6 days in the R group vs. 7 days in the V group, p = 0.4) with no significant difference in the rate of postoperative complications (eight Grade I in both groups, four Grade III or IV in the V group vs. six in the R group, according to the Clavien-Dindo classification, p = 0.93). No postoperative cardiac morbidity was observed in the R group. Median drainage time was similar (5 days, p = 0.78), with a rate of prolonged air leak slightly higher in the R group (25 vs. 17.8%, p = 0.74). Conclusion Perioperative outcomes are similar even in the learning period but robotic approach seems to offer more operative safety with fewer conversions for uncontrolled bleeding.
authors: Department of Thoracic Surgery, Rouen University Hospital, Rouen, France.
authors: Julien
authors: J
authors: Mahieu
authors: Department of Thoracic Surgery, Rouen University Hospital, Rouen, France.
authors: Philippe
authors: P
authors: Rinieri
authors: Department of Biostatistics, Rouen University Hospital, Rouen, France.
authors: Michael
authors: M
authors: Bubenheim
authors: Department of Anesthesiology, Rouen University Hospital, Rouen, France.
authors: Emile
authors: E
authors: Calenda
authors: Department of Thoracic Surgery, Rouen University Hospital, Rouen, France.
authors: Jean
authors: J
authors: Melki
authors: Department of Thoracic Surgery, Rouen University Hospital, Rouen, France.
authors: Christophe
authors: C
authors: Peillon
authors: Department of Thoracic Surgery, Rouen University Hospital, Rouen, France.
authors: Jean-Marc
authors: JM
authors: Baste
mesh_terms: D016063:Blood Loss, Surgical; D002983:Clinical Competence; D061887:Conversion to Open Surgery; D016208:Databases, Factual; D005260:Female; D005602:France; D006801:Humans; D059032:Learning Curve; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D011013:Pneumonectomy / Q000009:adverse effects / Q000379:methods*; D011183:Postoperative Complications / Q000209:etiology; D012189:Retrospective Studies; D012307:Risk Factors; D065287:Robotic Surgical Procedures / Q000009:adverse effects; D020775:Thoracic Surgery, Video-Assisted / Q000009:adverse effects; D013997:Time Factors; D016896:Treatment Outcome