Robot-assisted complex segmentectomy<italic/> versus<italic/> simple segmentectomy for stage ⅠA non-small cell lung cancer: A retrospective cohort study_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

HOU Yucheng , ZHANG Jianfeng , SONG Weijian , LUO Qingquan ,  ZHOU Qianjun

Department of Oncology Surgery, Shanghai Lung Tumor Clinical Medical Center, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, 200030, P. R. China;

Corresponding author：

ZHOU Qianjun, Email: zhouqj@sjtu.edu.cn

Keywords：

Da Vinci robot; non-small cell lung cancer; complex segmentectomy; simple segmentectomy; perioperative outcome

DOI：

10.7507/1007-4848.202112047

Video：

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Objective To compare the perioperative outcomes between robot-assisted complex segmentectomy and simple segmentectomy for stage ⅠA non-small cell lung cancer (NSCLC). Methods The clinical data of 285 patients with NSCLC undergoing robot-assisted thoracic surgery (RATS) in our hospital from January 2015 to August 2021 were retrospectively analyzed. There were 105 males and 180 females aged 23-83 years. The patients were divided into a complex segmentectomy group (n=170) and a simple segmentectomy group (n=115) according to tumor location and surgical method. The clinical pathological baseline characteristics and perioperative outcomes between the two groups were compared, including operative time, blood loss volume, dissected lymph nodes, conversion rate, postoperative duration of drainage, postoperative hospital stay, the incidence of persistent air leakage and postoperative 30 d mortality. Results There was no statistical difference in baseline data between the two groups (P>0.05). No postoperative 30 d death was observed. One patient in the complex segmentectomy group was transferred to thoracotomy. No statistical difference was observed between the two groups in the operative time (97.36±38.16 min vs. 94.65±31.67 min, P=0.515), postoperative duration of drainage (3.69±1.85 d vs. 3.60±1.90 d, P=0.679), postoperative hospital stay (4.07±1.85 d vs. 4.05±1.97 d, P=0.957), dissected lymph nodes (5.15±3.53 vs. 5.13±2.93, P=0.952), incidence of blood loss volume<100 mL (98.2% vs. 99.1%, P=0.650), and incidence of postoperative persistent air leakage (6.5% vs. 5.2%, P=0.661). Conclusion The safety and effectiveness of robot-assisted complex segmentectomy and simple segmentectomy are satisfactory in the treatment of stage ⅠA NSCLC. The perioperative results of RATS complex segmentectomy and simple segmentectomy are similar.

Citation： HOU Yucheng, ZHANG Jianfeng, SONG Weijian, LUO Qingquan, ZHOU Qianjun. Robot-assisted complex segmentectomy versus simple segmentectomy for stage ⅠA non-small cell lung cancer: A retrospective cohort study. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2022, 29(9): 1128-1132. doi: 10.7507/1007-4848.202112047 Copy

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2.	Goya T, Asamura H, Yoshimura H, et al. Prognosis of 6644 resected non-small cell lung cancers in Japan: A Japanese lung cancer registry study. Lung Cancer, 2005, 50(2): 227-234.
3.	Nakazawa S, Shimizu K, Mogi A, et al. VATS segmentectomy: Past, present, and future. Gen Thorac Cardiovasc Surg, 2018, 66(2): 81-90.
4.	Handa Y, Tsutani Y, Mimae T, et al. Surgical outcomes of complex versus simple segmentectomy for stageⅠ non-small cell lung cancer. Ann Thorac Surg, 2019, 107(4): 1032-1039.
5.	Handa Y, Tsutani Y, Mimae T, et al. Complex segmentectomy in the treatment of stage ⅠA non-small-cell lung cancer. Eur J Cardiothorac Surg, 2020, 57(1): 114-121.
6.	Pardolesi A, Park B, Petrella F, et al. Robotic anatomic segmentectomy of the lung: Technical aspects and initial results. Ann Thorac Surg, 2012, 94(3): 929-934.
7.	Yang CF, D'Amico TA. Open, thoracoscopic and robotic segmentectomy for lung cancer. Ann Cardiothorac Surg, 2014, 3(2): 142-152.
8.	Liang H, Liang W, Zhao L, et al. Robotic versus video-assisted lobectomy/segmentectomy for lung cancer: A meta-analysis. Ann Surg, 2018, 268(2): 254-259.
9.	Zhou Q, Huang J, Pan F, et al. Operative outcomes and long-term survival of robotic-assisted segmentectomy for stage ⅠA lung cancer compared with video-assisted thoracoscopic segmentectomy. Transl Lung Cancer Res, 2020, 9(2): 306-315.
10.	Handa Y, Tsutani Y, Mimae T, et al. Complex segmentectomy for hypermetabolic clinical stage ⅠA non-small cell lung cancer. Ann Thorac Surg, 2022, 113(4): 1317-1324.
11.	Siegel RL, Miller KD, Fuchs HE, et al. Cancer statistics, 2021. CA Cancer J Clin, 2021, 71(1): 7-33.
12.	Okada M, Sakamoto T, Nishio W, et al. Characteristics and prognosis of patients after resection of nonsmall cell lung carcinoma measuring 2 cm or less in greatest dimension. Cancer, 2003, 98(3): 535-541.
13.	Schuchert MJ, Pettiford BL, Keeley S, et al. Anatomic segmentectomy in the treatment of stage Ⅰ non-small cell lung cancer. Ann Thorac Surg, 2007, 84(3): 926-932.
14.	Tsutani Y, Miyata Y, Nakayama H, et al. Appropriate sublobar resection choice for ground glass opacity-dominant clinical stage ⅠA lung adenocarcinoma: Wedge resection or segmentectomy. Chest, 2014, 145(1): 66-71.
15.	Aokage K, Saji H, Suzuki K, et al. A non-randomized confirmatory trial of segmentectomy for clinical T1N0 lung cancer with dominant ground glass opacity based on thin-section computed tomography (JCOG1211). Gen Thorac Cardiovasc Surg, 2017, 65(5): 267-272.
16.	Kohman LJ, Gu L, Altorki N, et al. Biopsy first: Lessons learned from Cancer and Leukemia Group B (CALGB) 140503. J Thorac Cardiovasc Surg, 2017, 153(6): 1592-1597.
17.	Suzuki K, Saji H, Aokage K, et al. Comparison of pulmonary segmentectomy and lobectomy: Safety results of a randomized trial. J Thorac Cardiovasc Surg, 2019, 158(3): 895-907.
18.	陶绍霖, 康珀铭, 谭群友, 等. 经前侧入路达芬奇机器人辅助肺段切除术的临床分析. 中国胸心血管外科临床杂志, 2020, 27(2): 178-182.
19.	Mazzei M, Abbas AE. Why comprehensive adoption of robotic assisted thoracic surgery is ideal for both simple and complex lung resections. J Thorac Dis, 2020, 12(2): 70-81.

1. Ginsberg RJ, Rubinstein LV. Randomized trial of lobectomy versus limited resection for T1 N0 non-small cell lung cancer. Lung Cancer Study Group. Ann Thorac Surg, 1995, 60(3): 615-622.
2. Goya T, Asamura H, Yoshimura H, et al. Prognosis of 6644 resected non-small cell lung cancers in Japan: A Japanese lung cancer registry study. Lung Cancer, 2005, 50(2): 227-234.
3. Nakazawa S, Shimizu K, Mogi A, et al. VATS segmentectomy: Past, present, and future. Gen Thorac Cardiovasc Surg, 2018, 66(2): 81-90.
4. Handa Y, Tsutani Y, Mimae T, et al. Surgical outcomes of complex versus simple segmentectomy for stageⅠ non-small cell lung cancer. Ann Thorac Surg, 2019, 107(4): 1032-1039.
5. Handa Y, Tsutani Y, Mimae T, et al. Complex segmentectomy in the treatment of stage ⅠA non-small-cell lung cancer. Eur J Cardiothorac Surg, 2020, 57(1): 114-121.
6. Pardolesi A, Park B, Petrella F, et al. Robotic anatomic segmentectomy of the lung: Technical aspects and initial results. Ann Thorac Surg, 2012, 94(3): 929-934.
7. Yang CF, D'Amico TA. Open, thoracoscopic and robotic segmentectomy for lung cancer. Ann Cardiothorac Surg, 2014, 3(2): 142-152.
8. Liang H, Liang W, Zhao L, et al. Robotic versus video-assisted lobectomy/segmentectomy for lung cancer: A meta-analysis. Ann Surg, 2018, 268(2): 254-259.
9. Zhou Q, Huang J, Pan F, et al. Operative outcomes and long-term survival of robotic-assisted segmentectomy for stage ⅠA lung cancer compared with video-assisted thoracoscopic segmentectomy. Transl Lung Cancer Res, 2020, 9(2): 306-315.
10. Handa Y, Tsutani Y, Mimae T, et al. Complex segmentectomy for hypermetabolic clinical stage ⅠA non-small cell lung cancer. Ann Thorac Surg, 2022, 113(4): 1317-1324.
11. Siegel RL, Miller KD, Fuchs HE, et al. Cancer statistics, 2021. CA Cancer J Clin, 2021, 71(1): 7-33.
12. Okada M, Sakamoto T, Nishio W, et al. Characteristics and prognosis of patients after resection of nonsmall cell lung carcinoma measuring 2 cm or less in greatest dimension. Cancer, 2003, 98(3): 535-541.
13. Schuchert MJ, Pettiford BL, Keeley S, et al. Anatomic segmentectomy in the treatment of stage Ⅰ non-small cell lung cancer. Ann Thorac Surg, 2007, 84(3): 926-932.
14. Tsutani Y, Miyata Y, Nakayama H, et al. Appropriate sublobar resection choice for ground glass opacity-dominant clinical stage ⅠA lung adenocarcinoma: Wedge resection or segmentectomy. Chest, 2014, 145(1): 66-71.
15. Aokage K, Saji H, Suzuki K, et al. A non-randomized confirmatory trial of segmentectomy for clinical T1N0 lung cancer with dominant ground glass opacity based on thin-section computed tomography (JCOG1211). Gen Thorac Cardiovasc Surg, 2017, 65(5): 267-272.
16. Kohman LJ, Gu L, Altorki N, et al. Biopsy first: Lessons learned from Cancer and Leukemia Group B (CALGB) 140503. J Thorac Cardiovasc Surg, 2017, 153(6): 1592-1597.
17. Suzuki K, Saji H, Aokage K, et al. Comparison of pulmonary segmentectomy and lobectomy: Safety results of a randomized trial. J Thorac Cardiovasc Surg, 2019, 158(3): 895-907.
18. 陶绍霖, 康珀铭, 谭群友, 等. 经前侧入路达芬奇机器人辅助肺段切除术的临床分析. 中国胸心血管外科临床杂志, 2020, 27(2): 178-182.
19. Mazzei M, Abbas AE. Why comprehensive adoption of robotic assisted thoracic surgery is ideal for both simple and complex lung resections. J Thorac Dis, 2020, 12(2): 70-81.

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Robot-assisted complex segmentectomy versus simple segmentectomy for stage ⅠA non-small cell lung cancer: A retrospective cohort study

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