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Updated: Jul 17, 2026
Single-Port Robotic-assisted Transaxillary Breast-conserving Surgery: A Prospective, Single-arm, Non-randomized Phase IIa Clinical Trial
Published on: August 19, 2025
Outcomes of robotic vs video-assisted thoracoscopic segmentectomy in early-stage NSCLC: A meta-analysis of
Udochukwu Godswill Anosike1, Wellgner Fernandes Oliveira Amador2, Theodora Cristina Cruz de Assis3
1Nnamdi Azikiwe University, Nigeria.
Introduction:
Robotic-assisted thoracoscopic segmentectomy (RATS) has been increasingly adopted for early-stage non-small cell lung cancer (NSCLC), yet comparative effectiveness versus video-assisted thoracoscopic segmentectomy (VATS) remains uncertain. We performed a meta-analysis restricted to propensity-matched studies to compare perioperative and oncologic outcomes between approaches.
Methods:
A comprehensive literature search was conducted to identify studies comparing RATS and VATS. Pooled odds ratios (ORs) and mean differences (MDs) with 95% confidence intervals (CIs) were calculated using random-effects models. Overall survival (OS) was reconstructed from published Kaplan-Meier curves and analyzed using Cox proportional hazards models.
Results:
Five studies comprising 14,007 patients with 3,233 (23.1%) undergoing RATS were included. RATS was associated with lower intraoperative blood loss (MD -8.82, 95% CI -16.37 to -1.28, p = 0.02). Median overall survival was similar between groups at 4.6 years for both RATS and VATS (HR 0.98, 95% CI 0.90 to 1.08, p = 0.72). Operative time, cost, nodal assessment, chest drainage duration, hospital length of stay, conversion to thoracotomy, 30-day readmission, persistent air leak, atrial arrhythmia, and 90-day mortality were comparable.
Conclusions:
Both surgical approaches provide comparable perioperative safety and oncologic adequacy. Procedure selection should be individualized, taking into account surgeon expertise, case complexity, resource availability, and cost considerations.