Robotic and thoracoscopic segmentectomy in the treatment for non-small cell lung cancer: A propensity score-matched study_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

WU Xiao ¹ , XU Jinming ¹ , WANG Ying ² , NI Pengzhi ¹ , WANG Luming ¹ , HE Zhehao ¹ ,  HU Jian ¹

1. Department of Cardiovascular and Thoracic Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, 310000, P.R.China;
2. Department of Operating Room, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, 310000, P.R.China;

Corresponding author：

HU Jian, Email: dr_hujian@zju.edu.cn

Keywords：

Lung cancer; segmentectomy; robot-assisted surgery; video-assisted thoracic surgery (VATS); surgery

DOI：

10.7507/1007-4848.202007061

Video：

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Objective To investigate the safety and efficiency of robotic lung segmentectomy.Methods The clinical data of 110 patients receiving robotic or thoracoscopic segmentectomy in our hospital between June 2015 and June 2019 were retrospectively analyzed. The patients were divided into a robotic group [n=50, 13 males and 37 females aged 53.0 (46.0, 60.0) years] and a thoracoscopic group [n=60, 21 males and 39 females aged 61.0 (53.0, 67.0) years]. A propensity score-matched analysis was adopted to compare the perioperative data between the two groups.Results After the propensity score-matched analysis, 34 patients were included in each group. In comparison with the thoracoscopic group, patients in the robotic group had less blood loss [40.0 (20.0, 50.0) mL vs. 60.0 (40.0, 80.0) mL, P<0.001], more stations of lymph node dissection [7.0 (6.0, 8.0) vs. 4.0 (3.0, 6.0), P<0.001], larger number of lymph node dissection [15.0 (11.0, 21.0) vs. 10.0 (6.0, 14.0), P=0.002], and a higher total cost of hospitalization [97.0 (92.0, 103.0) thousand yuan vs. 54.0 (42.0, 59.0) thousand yuan, P<0.001].Conclusion In contrast with the thoracoscopic segmentectomy, robotic segmentectomy has a similar operative safety, but less blood loss and a thorough lymphadenectomy.

Citation： WU Xiao, XU Jinming, WANG Ying, NI Pengzhi, WANG Luming, HE Zhehao, HU Jian. Robotic and thoracoscopic segmentectomy in the treatment for non-small cell lung cancer: A propensity score-matched study. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2020, 27(10): 1150-1154. doi: 10.7507/1007-4848.202007061 Copy

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4.	Ghaly G, Kamel M, Nasar A, <italic>et al</italic>. Video-assisted thoracoscopic surgery is a safe and effective alternative to thoracotomy for anatomical segmentectomy in patients with clinical stageⅠnon-small cell lung cancer. Ann Thorac Surg, 2016, 101(2): 465-472.
5.	Pardolesi A, Park B, Petrella F, <italic>et al</italic>. Robotic anatomic segmentectomy of the lung: technical aspects and initial results. Ann Thorac Surg, 2012, 94(3): 929-934.
6.	Gharagozloo F, Margolis M, Tempesta B, <italic>et al</italic>. Robot-assisted lobectomy for early-stage lung cancer: report of 100 consecutive cases. Ann Thorac Surg, 2009, 88(2): 380-384.
7.	Ye B, Cheng M, Li W, <italic>et al</italic>. Predictive factors for lymph node metastasis in clinical stageⅠA lung adenocarcinoma. Ann Thorac Surg, 2014, 98(1): 217-223.
8.	Koike T, Koike T, Yamato Y, <italic>et al</italic>. Predictive risk factors for mediastinal lymph node metastasis in clinical stageⅠA non-small-cell lung cancer patients. J Thorac Oncol, 2012, 7(8): 1246-1251.
9.	Schuchert MJ, Pettiford BL, Pennathur A, <italic>et al</italic>. Anatomic segmentectomy for stageⅠnon-small-cell lung cancer: comparison of video-assisted thoracic surgery versus open approach. J Thorac Cardiovasc Surg, 2009, 138(6): 1318-1325.
10.	Geraci TC, Ferrari-Light D, Kent A, <italic>et al</italic>. Technique, outcomes with navigational bronchoscopy using indocyanine green for robotic segmentectomy. Ann Thorac Surg, 2019, 108(2): 363-369.
11.	Demir A, Ayalp K, Ozkan B, <italic>et al</italic>. Robotic and video-assisted thoracic surgery lung segmentectomy for malignant and benign lesions. Interact Cardiovasc Thorac Surg, 2015, 20(3): 304-309.
12.	Pardolesi A, Veronesi G. Robot-assisted lung anatomic segmentectomy: technical aspects. Thorac Surg Clin, 2014, 24(2): 163-168.
13.	Rinieri P, Peillon C, Salaün M, <italic>et al</italic>. Perioperative outcomes of video- and robot-assisted segmentectomies. Asian Cardiovasc Thorac Ann, 2016, 24(2): 145-151.
14.	Mungo B, Hooker CM, Ho JSY, <italic>et al</italic>. Robotic versus thoracoscopic resection for lung cancer: early results of a new robotic program. J Laparoendosc Adv Surg Tech A, 2016, 26(4): 243-248.
15.	杜祥民, 张永寿. 达芬奇手术机器人系统介绍及应用进展. 中国医学装备, 2011, 8(5): 60-63.
16.	嵇武, 李宁, 黎介寿. 我国机器人手术开展的现状与前景展望. 腹腔镜外科杂志, 2011, 16(2): 85-88.
17.	王先进, 钟山, 沈周俊. 机器人手术的经济学探讨. 上海医学, 2011, 34(1): 70-73.
18.	Wilson JL, Louie BE, Cerfolio RJ, <italic>et al</italic>. The prevalence of nodal upstaging during robotic lung resection in early stage non-small cell lung cancer. Ann Thorac Surg, 2014, 97(6): 1901-1906.
19.	Park BJ, Melfi F, Mussi A, <italic>et al</italic>. Robotic lobectomy for non-small cell lung cancer (NSCLC): long-term oncologic results. J Thorac Cardiovasc Surg, 2012, 143(2): 383-389.

1. Bray F, Ferlay J, Soerjomataram I, <italic>et al</italic>. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, 2018, 68(6): 394-424.
2. Church TR, Black WC, Aberle DR, <italic>et al</italic>. Results of initial low-dose computed tomographic screening for lung cancer. N Engl J Med, 2013, 368(21): 1980-1991.
3. Field JK, Oudkerk M, Pedersen JH, <italic>et al</italic>. Prospects for population screening and diagnosis of lung cancer. Lancet, 2013, 382(9893): 732-741.
4. Ghaly G, Kamel M, Nasar A, <italic>et al</italic>. Video-assisted thoracoscopic surgery is a safe and effective alternative to thoracotomy for anatomical segmentectomy in patients with clinical stageⅠnon-small cell lung cancer. Ann Thorac Surg, 2016, 101(2): 465-472.
5. Pardolesi A, Park B, Petrella F, <italic>et al</italic>. Robotic anatomic segmentectomy of the lung: technical aspects and initial results. Ann Thorac Surg, 2012, 94(3): 929-934.
6. Gharagozloo F, Margolis M, Tempesta B, <italic>et al</italic>. Robot-assisted lobectomy for early-stage lung cancer: report of 100 consecutive cases. Ann Thorac Surg, 2009, 88(2): 380-384.
7. Ye B, Cheng M, Li W, <italic>et al</italic>. Predictive factors for lymph node metastasis in clinical stageⅠA lung adenocarcinoma. Ann Thorac Surg, 2014, 98(1): 217-223.
8. Koike T, Koike T, Yamato Y, <italic>et al</italic>. Predictive risk factors for mediastinal lymph node metastasis in clinical stageⅠA non-small-cell lung cancer patients. J Thorac Oncol, 2012, 7(8): 1246-1251.
9. Schuchert MJ, Pettiford BL, Pennathur A, <italic>et al</italic>. Anatomic segmentectomy for stageⅠnon-small-cell lung cancer: comparison of video-assisted thoracic surgery versus open approach. J Thorac Cardiovasc Surg, 2009, 138(6): 1318-1325.
10. Geraci TC, Ferrari-Light D, Kent A, <italic>et al</italic>. Technique, outcomes with navigational bronchoscopy using indocyanine green for robotic segmentectomy. Ann Thorac Surg, 2019, 108(2): 363-369.
11. Demir A, Ayalp K, Ozkan B, <italic>et al</italic>. Robotic and video-assisted thoracic surgery lung segmentectomy for malignant and benign lesions. Interact Cardiovasc Thorac Surg, 2015, 20(3): 304-309.
12. Pardolesi A, Veronesi G. Robot-assisted lung anatomic segmentectomy: technical aspects. Thorac Surg Clin, 2014, 24(2): 163-168.
13. Rinieri P, Peillon C, Salaün M, <italic>et al</italic>. Perioperative outcomes of video- and robot-assisted segmentectomies. Asian Cardiovasc Thorac Ann, 2016, 24(2): 145-151.
14. Mungo B, Hooker CM, Ho JSY, <italic>et al</italic>. Robotic versus thoracoscopic resection for lung cancer: early results of a new robotic program. J Laparoendosc Adv Surg Tech A, 2016, 26(4): 243-248.
15. 杜祥民, 张永寿. 达芬奇手术机器人系统介绍及应用进展. 中国医学装备, 2011, 8(5): 60-63.
16. 嵇武, 李宁, 黎介寿. 我国机器人手术开展的现状与前景展望. 腹腔镜外科杂志, 2011, 16(2): 85-88.
17. 王先进, 钟山, 沈周俊. 机器人手术的经济学探讨. 上海医学, 2011, 34(1): 70-73.
18. Wilson JL, Louie BE, Cerfolio RJ, <italic>et al</italic>. The prevalence of nodal upstaging during robotic lung resection in early stage non-small cell lung cancer. Ann Thorac Surg, 2014, 97(6): 1901-1906.
19. Park BJ, Melfi F, Mussi A, <italic>et al</italic>. Robotic lobectomy for non-small cell lung cancer (NSCLC): long-term oncologic results. J Thorac Cardiovasc Surg, 2012, 143(2): 383-389.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Robotic and thoracoscopic segmentectomy in the treatment for non-small cell lung cancer: A propensity score-matched study

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