Uniportal Robotic-Assisted Versus Video-Assisted Thoracoscopic Surgery for Anatomical Lung Resection in Non-Small...

Area of Science:

• Thoracic Surgery
• Surgical Oncology
• Minimally Invasive Surgery

Background:

• Direct comparisons of uniportal robotic-assisted surgery (uRATS) and uniportal video-assisted surgery (uVATS) for non-small cell lung cancer (NSCLC) are limited.
• This study addresses the scarcity of data by comparing oncologic radicality and perioperative outcomes between these two uniportal approaches.

Purpose of the Study:

• To compare the oncologic radicality and perioperative outcomes of uniportal robotic-assisted thoracoscopic surgery (uRATS) versus uniportal video-assisted thoracoscopic surgery (uVATS) for non-small cell lung cancer (NSCLC).

Main Methods:

• A retrospective cohort study of 56 consecutive NSCLC patients undergoing uniportal anatomical resection (12 uRATS, 44 uVATS).
• Primary endpoint: oncologic radicality (lymph node dissection quality).
• Secondary endpoints: operative time, blood loss, pain, recovery metrics, and textbook outcome.

Main Results:

• All patients achieved complete (R0) resection.
• uRATS group showed significantly more lymph nodes dissected (13 vs. 7; p=0.049) and a trend towards more mediastinal stations sampled (4 vs. 3; p=0.061).
• uRATS was associated with longer operative time (220 vs. 135 min; p<0.001) but favored uRATS for reduced air-leak duration (0 vs. 2 days; p<0.001), shorter hospital stay (2 vs. 3 days; p=0.022), and less discharge pain (p=0.017).

Conclusions:

• In a uniportal-experienced center, uRATS demonstrated comparable intraoperative oncologic quality to uVATS for NSCLC.
• Perioperative recovery metrics significantly favored uRATS.
• Larger multicenter studies with extended follow-up are recommended to further validate these findings.