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Updated: Feb 26, 2026

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Does Robotic Segmentectomy Improve Long-Term Outcomes in Non-Small Cell Lung Cancer?

Nabih Berjaoui1,2,3, Giulia Fabbri2, Savvas Lampridis2

  • 1Department of Medicine - DIMED, University of Padua, Italy.

European Journal of Cardio-Thoracic Surgery : Official Journal of the European Association for Cardio-Thoracic Surgery
|February 25, 2026
PubMed
Summary

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Robotic-assisted thoracic surgery (RATS) segmentectomy shows improved survival and reduced recurrence for lung cancer compared to video-assisted thoracic surgery (VATS). RATS offers better lymphadenectomy and wider margins with similar short-term outcomes.

Area of Science:

  • Thoracic Surgery
  • Surgical Oncology
  • Minimally Invasive Surgery

Background:

  • Lung cancer is a leading global cause of cancer death.
  • Segmentectomy is a viable alternative to lobectomy for small, early-stage lung cancers.
  • Robotic-assisted thoracic surgery (RATS) offers potential precision advantages over video-assisted thoracic surgery (VATS).

Purpose of the Study:

  • To compare short-term and long-term outcomes of RATS versus VATS segmentectomy for non-small cell lung cancer (NSCLC).
  • To evaluate survival rates, recurrence, and perioperative complications between the two surgical approaches.

Main Methods:

  • Retrospective review of 144 patients undergoing RATS or VATS segmentectomy for NSCLC (July 2015 - December 2021).
  • Primary outcomes: overall survival (OS), disease-free survival (DFS), recurrence.
Keywords:
long-term outcomeslymphadenectomynon-small cell lung cancerrobotic-assisted thoracic surgerysegmentectomyvideo-assisted thoracic surgery

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  • Secondary outcomes: complications, length of stay, drainage duration, lymph node yield.

    • Main Results:

    • RATS group (n=86) had more lymph node stations harvested and wider tumor-free margins than VATS group (n=58).
    • Short-term outcomes (complications, length of stay, operative time) were similar between RATS and VATS.
    • Long-term outcomes favored RATS, showing significantly improved OS, DFS, and lower recurrence rates.

    Conclusions:

    • RATS segmentectomy provides superior long-term oncologic outcomes compared to VATS segmentectomy for NSCLC.
    • The enhanced lymphadenectomy and wider resection margins achieved with RATS may contribute to its survival benefits.
    • RATS is a promising approach for NSCLC segmentectomy, maintaining comparable perioperative results.