Comparison of RATS Lobectomy and VATS Lobectomy for Early-stage Non-small Cell Lung Cancer

Area of Science:

• Thoracic Surgery
• Surgical Oncology
• Minimally Invasive Procedures

Background:

• Robotic-assisted thoracoscopic surgery (RATS) is increasingly used for early-stage non-small cell lung cancer (NSCLC).
• Comparative data on RATS versus video-assisted thoracoscopic surgery (VATS) for early NSCLC are essential to evaluate safety and oncological outcomes.

Purpose of the Study:

• To compare the safety and oncological efficacy of RATS and VATS lobectomy in patients with stage 0 or I NSCLC.
• To evaluate perioperative and clinicopathological outcomes between RATS and VATS for early-stage NSCLC.

Main Methods:

• Retrospective analysis of 330 patients with stage 0 or I NSCLC undergoing RATS (n=144) or VATS (n=186) lobectomy.
• Propensity score matching was used to analyze perioperative and clinicopathological outcomes, including blood loss and lymph node dissection.

Main Results:

• RATS demonstrated significantly lower intraoperative blood loss compared to VATS.
• No significant differences were observed in operative time, complications, or hospital stay between RATS and VATS.
• Lymph node yields were comparable between RATS and VATS after propensity score matching.

Conclusions:

• Both RATS and VATS lobectomies are safe and effective for early-stage NSCLC.
• RATS offers comparable perioperative outcomes to VATS with the advantage of reduced blood loss.
• RATS provides oncological quality equivalent to VATS for early-stage NSCLC, supporting its adoption.