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Updated: Oct 2, 2025
Subcostal Specimen Removal in Completely Portal Robotic Lobectomy
Published on: April 19, 2024
Surgical site infection following minimally invasive lobectomy: Is robotic surgery superior?
Yucheng Hou1, Yeyan Hu1, Weijian Song1
1Department of Thoracic Surgery, Shanghai Lung Cancer Center, Shanghai Chest Hospital, Shanghai Jiaotong University, School of Medicine, Shanghai, China.
Background:
Surgical site infection (SSI) in thoracic surgery remains a significant cause of morbidity and prolonged hospitalization. Minimally invasive surgery (MIS) has significantly reduced the risk of SSI. We intended to compare whether there was difference between video-assisted thoracic surgery (VATS) and robotic-assisted thoracic surgery (RATS) in SSI and highlight possible factors influencing SSI in lobectomy.
Methods:
This retrospective study analyzed patients who underwent minimally invasive lobectomy from January 2018 to December 2019. All patients' clinical characteristics and surgery-related information which may be related to the likelihood of SSI were recorded.
Results:
A total of 1231 patients' records were reviewed with 806 VATS and 425 RATS. SSI was classified as deep or superficial SSI. Eighty-six (7.0%) patients were found to develop an SSI with 62 patients having deep infections and 24 had superficial infection. No statistical difference in the incidence rate and category of SSI was observed between patients undergoing VATS and RATS.
Conclusions:
There was no difference in the incidence of SSI between VATS and RATS lobectomy. Male gender, heavy smoking, uncontrolled diabetes mellitus, body mass index (BMI) > 27.9, more blood loss, and the higher National Healthcare Safety Network (NHSN) risk index score (1 or 2) were the independent risk factors of SSI following minimally invasive lobectomy, while male gender, uncontrolled diabetes mellitus, BMI > 27.9, more blood loss and the higher NHSN risk index score (1 or 2) were the main predictors of deep SSI.
Insights
Minimally invasive lobectomy via video-assisted thoracic surgery (VATS) or robotic-assisted thoracic surgery (RATS) shows no difference in surgical site infection (SSI) rates. Key risk factors for SSI include male gender, smoking, and higher BMI.
Area of Science:
- Thoracic Surgery
- Minimally Invasive Surgery
- Surgical Site Infections
Background:
- Surgical site infection (SSI) is a major complication in thoracic surgery, leading to increased morbidity and hospital stays.
- Minimally invasive surgery (MIS) techniques have been developed to reduce SSI risk.
- Video-assisted thoracic surgery (VATS) and robotic-assisted thoracic surgery (RATS) are common MIS approaches for lobectomy.
Purpose of the Study:
- To compare the incidence and types of SSI between VATS and RATS in lobectomy procedures.
- To identify independent risk factors associated with SSI following minimally invasive lobectomy.
Main Methods:
- A retrospective analysis of 1231 patients who underwent minimally invasive lobectomy between January 2018 and December 2019.
- Data collected included patient demographics, clinical characteristics, and surgery-related information.
- SSI was categorized as deep or superficial.
Main Results:
- No statistically significant difference was found in the overall incidence or category of SSI between VATS and RATS groups.
- A total of 7.0% of patients developed SSI, with 62 deep and 24 superficial infections.
- The study included 806 VATS cases and 425 RATS cases.
Conclusions:
- The incidence of SSI is comparable between VATS and RATS lobectomy.
- Independent risk factors for SSI include male gender, heavy smoking, uncontrolled diabetes mellitus, BMI > 27.9, increased blood loss, and higher NHSN risk score.
- Predictors for deep SSI are similar, excluding smoking.
