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Thorac Cardiovasc Surg 2016; 64(04): 354-362
DOI: 10.1055/s-0035-1548733
Original Thoracic
Georg Thieme Verlag KG Stuttgart · New York

Robot-Assisted Thoracoscopic Surgery versus Video-Assisted Thoracoscopic Surgery for Lung Lobectomy: Can a Robotic Approach Improve Short-Term Outcomes and Operative Safety?

Julien Mahieu
1   Department of Thoracic Surgery, Rouen University Hospital, Rouen, France
,
Philippe Rinieri
1   Department of Thoracic Surgery, Rouen University Hospital, Rouen, France
,
Michael Bubenheim
2   Department of Biostatistics, Rouen University Hospital, Rouen, France
,
Emile Calenda
3   Department of Anesthesiology, Rouen University Hospital, Rouen, France
,
Jean Melki
1   Department of Thoracic Surgery, Rouen University Hospital, Rouen, France
,
Christophe Peillon
1   Department of Thoracic Surgery, Rouen University Hospital, Rouen, France
,
Jean-Marc Baste
1   Department of Thoracic Surgery, Rouen University Hospital, Rouen, France
› Author Affiliations
Further Information

Publication History

25 September 2014

08 February 2015

Publication Date:
13 April 2015 (online)

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Abstract

Background Minimally invasive surgery has been recently recommended for treatment of early-stage non–small cell lung cancer. Despite the recent increase of robotic surgery, the place and potential advantages of the robot in thoracic surgery has not been well defined until now.

Methods We reviewed our prospective database for retrospective comparison of our first 28 video-assisted thoracoscopic surgery lobectomies (V group) and our first 28 robotic lobectomies (R group).

Results No significant difference was shown in median operative time between the two groups (185 vs. 190 minutes, p = 0.56). Median preincision time was significantly longer in the R group (80 vs. 60 minutes, P < 0.0001). The rate of emergency conversion for uncontrolled bleeding was lower in the R group (one vs. four). Median length of stay was comparable (6 days in the R group vs. 7 days in the V group, p = 0.4) with no significant difference in the rate of postoperative complications (eight Grade I in both groups, four Grade III or IV in the V group vs. six in the R group, according to the Clavien–Dindo classification, p = 0.93). No postoperative cardiac morbidity was observed in the R group. Median drainage time was similar (5 days, p = 0.78), with a rate of prolonged air leak slightly higher in the R group (25 vs. 17.8%, p = 0.74).

Conclusion Perioperative outcomes are similar even in the learning period but robotic approach seems to offer more operative safety with fewer conversions for uncontrolled bleeding.

Keywords

lung cancer treatment - minimally invasive surgery - robotics - thoracoscopy/VATS
 

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