Comparison of pulmonary function tests and perioperative outcomes after robotic-assisted pulmonary lobectomy vs segmentectomy.
BACKGROUND
Lobectomy is standard treatment for early-stage lung cancer, but sublobar resection remains debated. We compared outcomes after robotic-assisted video-assisted thoracoscopic (R-VATS) segmentectomy vs lobectomy.


METHODS
We retrospectively analyzed data from 251 consecutive patients who underwent R-VATS lobectomy (n = 208) or segmentectomy (n = 43) by a single surgeon over 36 months. Pulmonary function tests and perioperative outcomes were compared using Chi-squared test, unpaired Student t test, or Kruskal-Wallis test, with significance at P ≤ .05.


RESULTS
Intraoperative complications were not significantly different, but median operative times were longer for R-VATS segmentectomies (P < .01). Postoperative complications were not significantly different, except for increased rates of pneumothorax after chest tube removal (P = .032) and of effusions or empyema (P = .011) after R-VATS segmentectomies. Predicted changes for forced expiratory volume in 1 second and diffusion constant of the lung for carbon monoxide are significantly less after R-VATS segmentectomy (P < .001).


CONCLUSIONS
R-VATS segmentectomy should be considered as an alternative to lobectomy for conserving lung function in respiratory-compromised lung cancer patients, although oncologic efficacy remains undetermined.
Morsani College of Medicine, University of South Florida, Tampa, FL, USA.
Maria F
MF
Echavarria
Morsani College of Medicine, University of South Florida, Tampa, FL, USA.
Anna M
AM
Cheng
Department of Surgery, University of South Florida, Morsani College of Medicine, 12901 Bruce B Downs Blvd., Tampa, FL 33612, USA.
Frank O
FO
Velez-Cubian
Morsani College of Medicine, University of South Florida, Tampa, FL, USA.
Emily P
EP
Ng
Department of Thoracic Oncology, Moffitt Cancer Center, 12902 USF Magnolia Dr., Suite FOB-1, Tampa, FL, USA.
Carla C
CC
Moodie
Department of Thoracic Oncology, Moffitt Cancer Center, 12902 USF Magnolia Dr., Suite FOB-1, Tampa, FL, USA.
Joseph R
JR
Garrett
Department of Surgery, University of South Florida, Morsani College of Medicine, 12901 Bruce B Downs Blvd., Tampa, FL 33612, USA; Department of Thoracic Oncology, Moffitt Cancer Center, 12902 USF Magnolia Dr., Suite FOB-1, Tampa, FL, USA; Department of Oncologic Sciences, University of South Florida, Morsani College of Medicine, 12901 Bruce B Downs Blvd., Tampa, FL 33612, USA.
Jacques P
JP
Fontaine
Department of Surgery, University of South Florida, Morsani College of Medicine, 12901 Bruce B Downs Blvd., Tampa, FL 33612, USA; Department of Thoracic Oncology, Moffitt Cancer Center, 12902 USF Magnolia Dr., Suite FOB-1, Tampa, FL, USA; Department of Oncologic Sciences, University of South Florida, Morsani College of Medicine, 12901 Bruce B Downs Blvd., Tampa, FL 33612, USA.
Lary A
LA
Robinson
Department of Surgery, University of South Florida, Morsani College of Medicine, 12901 Bruce B Downs Blvd., Tampa, FL 33612, USA; Department of Thoracic Oncology, Moffitt Cancer Center, 12902 USF Magnolia Dr., Suite FOB-1, Tampa, FL, USA; Department of Oncologic Sciences, University of South Florida, Morsani College of Medicine, 12901 Bruce B Downs Blvd., Tampa, FL 33612, USA. Electronic address: eric.toloza@moffitt.org.
Eric M
EM
Toloza
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000601:surgery*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D011013:Pneumonectomy; D012129:Respiratory Function Tests; D012189:Retrospective Studies; D065287:Robotic Surgical Procedures; D020775:Thoracic Surgery, Video-Assisted; D016896:Treatment Outcome; D055815:Young Adult
Lobectomy; Lung cancer; Outcomes; Pulmonary function; Robotic surgery; Segmentectomy