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

Robotic-assisted thoracoscopic surgery (RATS) has emerged as an alternative to video-assisted thoracoscopic surgery (VATS) for lobectomy in early-stage non-small cell lung cancer (NSCLC). While perioperative and oncologic outcomes have been studied, limited data exist on long-term postoperative pulmonary function. This study compared pulmonary function one year after RATS versus VATS lobectomy.

We retrospectively analyzed 298 patients who underwent lobectomy for early-stage NSCLC between September 2020 and August 2023. After applying exclusion criteria, 186 patients remained: 128 in the VATS group and 58 in the RATS group. Propensity score matching (1:1) yielded 55 matched pairs. Pulmonary function parameters-%predicted forced vital capacity (%FVC), %predicted forced expiratory volume in one second (%FEV1), %predicted peak expiratory flow (%PEF), and %predicted diffusing capacity for carbon monoxide (%DLco)-were evaluated one year postoperatively.

No significant differences were observed between groups in any pulmonary function parameters at one year, both before and after matching. Lung function was similarly preserved.

Despite the use of more ports, RATS lobectomy did not result in inferior pulmonary function compared to VATS. Given its higher cost, VATS may remain the more cost-effective standard, although RATS offers a promising platform for future innovation.