title: Comparison of robotic and video-assisted thoracic surgery for lung cancer: a propensity-matched analysis.
abstract: BACKGROUND
  Reports of comparison between robotic and thoracoscopic surgery for lung cancer are limited, we aimed to compare the perioperative outcomes of robotic and thoracoscopic anatomic pulmonary resection for lung cancer.
  
  
  METHODS
  A total of 184 patients with lung cancer underwent anatomic pulmonary resection by robotics or thoracoscopy. A propensity-matched analysis with incorporated preoperative variables was used to compare the perioperative outcomes between the two procedures.
  
  
  RESULTS
  Overall, 71 patients underwent robotic pulmonary resection, including 64 lobectomies and 7 segmentectomies, while 113 patients underwent thoracoscopic lobectomy and segmentectomy. Propensity match produced 69 pairs. The mean length of postoperative stay (7.6±4.6 vs. 6.4±2.6 d, P=0.078), chest tube duration (5.3±3.7 vs. 4.4±1.7 d, P=0.056), number of lymph nodes retrieved (17.9±6.9 vs. 17.4±7.0, P=0.660), stations of lymph nodes resected (7.4±1.6 vs. 7.6±1.7, P=0.563), operative blood loss (53.9±29.3 vs. 50.3±37.9 mL, P=0.531), morbidity rates (42.0% vs. 30.4%, P=0.157) were similar between the robotics and thoracoscopy. However, robotics was associated with higher cost ($12,067±1,610 vs. $8,328±1,004, P<0.001), and longer operative time (136±40 vs. 111±28 min, P<0.001).
  
  
  CONCLUSIONS
  Robotics seems to have higher hospital costs and longer operative time, without superior advantages in morbidity rates and oncologic efficiency. Further prospective randomized clinical trials were needed to validate both of its short- and long-term oncologic efficiency.
authors: Department of Thoracic Surgery, First Affiliated Hospital of Zhejiang University, Hangzhou 310003, China.
authors: Feichao
authors: F
authors: Bao
authors: Department of Thoracic Surgery, First Affiliated Hospital of Zhejiang University, Hangzhou 310003, China.
authors: Chong
authors: C
authors: Zhang
authors: Department of Thoracic Surgery, First Affiliated Hospital of Zhejiang University, Hangzhou 310003, China.
authors: Yunhai
authors: Y
authors: Yang
authors: Department of Thoracic Surgery, First Affiliated Hospital of Zhejiang University, Hangzhou 310003, China.
authors: Zhehao
authors: Z
authors: He
authors: Department of Thoracic Surgery, First Affiliated Hospital of Zhejiang University, Hangzhou 310003, China.
authors: Luming
authors: L
authors: Wang
authors: Department of Thoracic Surgery, First Affiliated Hospital of Zhejiang University, Hangzhou 310003, China.
authors: Jian
authors: J
authors: Hu
keywords: Robotics; lung cancer; video-assisted thoracic surgery (VATS)