Robot-assisted thoracic surgery for stages IIB–IVA non-small cell lung cancer: retrospective study of feasibility and outcome

Robot-assisted thoracic surgery (RATS) for higher stages non-small cell lung carcinoma (NSCLC) remains controversial. This study reports the feasibility of RATS in patients with stages IIB–IVA NSCLC. A single-institute, retrospective study was conducted with patients undergoing RATS for stages IIB–I...

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Bibliographic Details
Published in:Journal of robotic surgery 2023-08, Vol.17 (4), p.1587-1598
Main Authors: Shahin, Ghada M. M., Vos, Peter-Paul W. K., Hutteman, Merlijn, Stigt, Jos A., Braun, Jerry
Format: Article
Language:English
Subjects:
Carcinoma, Non-Small-Cell Lung - surgery
Disease
Dissection
Feasibility Studies
Humans
Learning curves
Lung cancer
Lung Neoplasms - surgery
Lymphatic system
Medical imaging
Medicine
Medicine & Public Health
Metastasis
Minimally Invasive Surgery
Neoplasm Staging
Ostomy
Patients
Pulmonary arteries
Recovery (Medical)
Retrospective Studies
Robotic surgery
Robotic Surgical Procedures - methods
Robotics
Surgeons
Surgery
Surgical techniques
Survival
Thoracic Surgery
Tomography
Treatment Outcome
Tumors
Ultrasonic imaging
Urology
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Summary:Robot-assisted thoracic surgery (RATS) for higher stages non-small cell lung carcinoma (NSCLC) remains controversial. This study reports the feasibility of RATS in patients with stages IIB–IVA NSCLC. A single-institute, retrospective study was conducted with patients undergoing RATS for stages IIB–IVA NSCLC, from January 2015 until January 2020. Unforeseen N2 disease was excluded. Data were collected from the Dutch Lung Cancer Audit database. Conversion rate, radical (R0) resection rate, local recurrence rate and complications were analyzed, as were risk factors for conversion. RATS was performed in 95 patients with NSCLC clinical or pathological stages IIB ( N  = 51), IIIA ( N  = 39), IIIB ( N  = 2) and IVA ( N  = 3). 10.5% had received neoadjuvant chemoradiotherapy. Pathological staging was T3 in 33.7% and T4 in 34.7%. RATS was completed in 77.9% with a radical resection rate of 94.8%. Lobectomy was performed in 67.4% of the total resections. Conversion was for strategic (18.9%) and emergency (3.2%) reasons. Pneumonectomy ( p  = 0.001), squamous cell carcinoma ( p  
ISSN:1863-2491
1863-2483
1863-2491
DOI:10.1007/s11701-023-01549-3