Postoperative Lung Function after Robotic- versus Video-Assisted Thoracoscopic Lobectomy for Lung Cancer: A...

Area of Science:

• Thoracic Surgery
• Pulmonary Function Testing
• Surgical Oncology

Background:

• Robotic-assisted thoracoscopic surgery (RATS) is an alternative to video-assisted thoracoscopic surgery (VATS) for early-stage non-small cell lung cancer (NSCLC) lobectomy.
• While perioperative and oncologic outcomes are known, long-term pulmonary function data after RATS vs. VATS is limited.

Purpose of the Study:

• To compare pulmonary function one year after RATS versus VATS lobectomy in patients with early-stage NSCLC.
• To assess the impact of surgical approach on long-term lung function preservation.

Main Methods:

• Retrospective analysis of 186 patients (128 VATS, 58 RATS) with early-stage NSCLC.
• Propensity score matching created 55 matched pairs for comparison.
• Pulmonary function parameters including %FVC, %FEV1, %PEF, and %DLco were evaluated one year postoperatively.

Main Results:

• No significant differences in %FVC, %FEV1, %PEF, or %DLco were observed between RATS and VATS groups at one year, both before and after matching.
• Pulmonary function was similarly preserved in both surgical groups.
• Lung function outcomes were comparable between robotic and conventional thoracoscopic approaches.

Conclusions:

• RATS lobectomy does not lead to inferior pulmonary function compared to VATS, despite potentially using more ports.
• VATS may remain the more cost-effective standard due to RATS' higher cost.
• RATS presents a promising platform for future advancements in minimally invasive thoracic surgery.