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Initial experience of robotic anatomical segmentectomy for non-small cell lung cancer
Atsushi Kagimoto1, Yasuhiro Tsutani1, Yu Izaki1
1Department of Surgical Oncology, Hiroshima University Hospital, Hiroshima, Japan.
Objective:
Anatomical segmentectomy has the potential to replace lobectomy as the standard procedure for early stage non-small cell lung cancer. We investigated the safety and feasibility of robotic anatomical segmentectomy for non-small cell lung cancer.
Methods:
Overall 20 patients underwent robotic anatomical segmentectomy at Hiroshima University Hospital between January 2014 and January 2018. The clinicopathological characteristics, surgical outcomes, complications and prognosis were analyzed.
Results:
The median age was 68 (range 42-86) years, and 15 patients were female. Six patients were non-smokers. The most common clinical stage was IA1 (nine patients). Complex segmentectomies were performed in four patients (one right S3 segmentectomy, two right S8 segmentectomies and one left S8 + S9 segmentectomy). The median operation time was 163.5 (range, 114-314) minutes, and the median console time was 104 (range, 60-246) minutes. The median blood loss was 26.5 (range, 5-247) ml. The median resection margin and number of dissected lymph node were 15 (range, 2-60) mm and 5 (range, 1-15), respectively. Although five (25.0%) patients had grade IIIa complications (pleurodesis for prolonged air leakage) and one (5.0%) had a grade IIIb complication (reoperation for prolonged air leakage), no post-operative deaths occurred. The surgical outcomes were comparable with those of anatomical segmentectomy performed under hybrid video-assisted thoracoscopic surgery during the same period.
Conclusion:
In our initial experience of robotic anatomical segmentectomy for early stage non-small cell lung cancer, the procedure seems to be safe and feasible.
Insights
Robotic anatomical segmentectomy is a safe and feasible option for early-stage non-small cell lung cancer. This minimally invasive approach shows promising surgical outcomes and a low complication rate in initial patient studies.
Area of Science:
- Thoracic surgery
- Surgical oncology
- Minimally invasive procedures
Background:
- Anatomical segmentectomy is emerging as a potential alternative to lobectomy for early-stage non-small cell lung cancer.
- Robotic surgery offers enhanced precision and visualization for complex thoracic procedures.
Purpose of the Study:
- To evaluate the safety and feasibility of robotic anatomical segmentectomy for non-small cell lung cancer.
- To assess surgical outcomes, complications, and prognosis associated with this technique.
Main Methods:
- A retrospective analysis of 20 patients who underwent robotic anatomical segmentectomy for non-small cell lung cancer.
- Data collected included clinicopathological characteristics, operative details, complications, and follow-up outcomes.
Main Results:
- The median patient age was 68 years, with a majority being female. Most patients were diagnosed at clinical stage IA1.
- Complex segmentectomies were performed in 4 patients. Median operation time was 163.5 minutes, and median console time was 104 minutes.
- While 25% experienced grade IIIa complications and 5% had grade IIIb complications, no post-operative deaths occurred. Outcomes were comparable to hybrid thoracoscopic surgery.
Conclusions:
- Robotic anatomical segmentectomy demonstrates safety and feasibility in the initial experience with early-stage non-small cell lung cancer.
- This approach represents a viable minimally invasive option for lung cancer treatment.
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