Robot-assisted vs. video-assisted thoracoscopic surgery in lung cancer
Masahiro Miyajima, Ryunosuke Maki, Wataru Arai, Kodai Tsuruta, Yuma Shindo, Yasuyuki Nakamura, Atsushi Watanabe
Abstract
Background: The major advantages of robot-assisted surgery are the fine field of view provided by the high-precision three-dimensional (3D) images and the good operability provided by the robotic arms that enables precise movements. A growing number of retrospective studies have compared robotic-assisted thoracoscopic surgery (RATS) with video-assisted thoracoscopic surgery (VATS), but the number of cases is limited and the results are contradictory. Methods: We studied the medical records of primary lung cancer patients who underwent lobectomy with lymph node dissection between 2017 and 2020. Four hundred and eleven patients fulfilled the inclusion criteria in this study (RATS: 103; VATS: 308). We compared the perioperative factors and postoperative results of the VATS and RATS groups. Further, we adjusted background factors using propensity score matching (PSM) then compared the results of 200 patients (100 patients in each group). In this study, we matched interlobar fissure completeness, which affects operative difficulty and operative time; however, this has been superficially compared in previous studies. Results: 11.5 days, P=0.04). Conclusions: Initial experience of RATS had no obvious drawbacks when compared with that of VATS on propensity-matched analysis.