title: Perioperative outcomes of video- and robot-assisted segmentectomies.
abstract: OBJECTIVE
  Video-assisted thoracic surgery appears to be technically difficult for segmentectomy. Conversely, robotic surgery could facilitate the performance of segmentectomy. The aim of this study was to compare the early results of video- and robot-assisted segmentectomies.
  
  
  METHODS
  Data were collected prospectively on videothoracoscopy from 2010 and on robotic procedures from 2013. Fifty-one patients who were candidates for minimally invasive segmentectomy were included in the study. Perioperative outcomes of video-assisted and robotic segmentectomies were compared.
  
  
  RESULTS
  The minimally invasive segmentectomies included 32 video- and 16 robot-assisted procedures; 3 segmentectomies (2 video-assisted and 1 robot-assisted) were converted to lobectomies. Four conversions to thoracotomy were necessary for anatomical reason or arterial injury, with no uncontrolled bleeding in the robotic arm. There were 7 benign or infectious lesions, 9 pre-invasive lesions, 25 lung cancers, and 10 metastatic diseases. Patient characteristics, type of segment, conversion to thoracotomy, conversion to lobectomy, operative time, postoperative complications, chest tube duration, postoperative stay, and histology were similar in the video and robot groups. Estimated blood loss was significantly higher in the video group (100 vs. 50 mL, p = 0.028).
  
  
  CONCLUSIONS
  The morbidity rate of minimally invasive segmentectomy was low. The short-term results of video-assisted and robot-assisted segmentectomies were similar, and more data are required to show any advantages between the two techniques. Long-term oncologic outcomes are necessary to evaluate these new surgical practices.
authors.affiliation: Department of General and Thoracic Surgery, Rouen University Hospital, Rouen, France philippe.rinieri@chu-rouen.fr.
authors.forename: Philippe
authors.initials: P
authors.lastname: Rinieri
authors.affiliation: Department of General and Thoracic Surgery, Rouen University Hospital, Rouen, France.
authors.forename: Christophe
authors.initials: C
authors.lastname: Peillon
authors.affiliation: Department of Pneumology, Rouen University Hospital, Rouen, France.
authors.forename: Mathieu
authors.initials: M
authors.lastname: Salaün
authors.affiliation: Department of General and Thoracic Surgery, Rouen University Hospital, Rouen, France.
authors.forename: Julien
authors.initials: J
authors.lastname: Mahieu
authors.affiliation: Department of Epidemiology and Public Health, Unit of Biostatistics, Rouen University Hospital, Rouen, France.
authors.forename: Michael
authors.initials: M
authors.lastname: Bubenheim
authors.affiliation: Department of General and Thoracic Surgery, Rouen University Hospital, Rouen, France.
authors.forename: Jean-Marc
authors.initials: JM
authors.lastname: Baste
mesh_terms: D000368:Aged; D016063:Blood Loss, Surgical; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D011013:Pneumonectomy / Q000009:adverse effects / Q000379:methods*; D011183:Postoperative Complications / Q000209:etiology; D011446:Prospective Studies; D065287:Robotic Surgical Procedures / Q000009:adverse effects; D020775:Thoracic Surgery, Video-Assisted / Q000009:adverse effects; D013997:Time Factors; D016896:Treatment Outcome
keywords: Lung neoplasms; Pneumonectomy; Postoperative complications; Robotics; Thoracic surgery; video-assisted