Ureña Anna, Moreno Camilo, Macia Ivan, Rivas Francisco, Déniz Carlos, Muñoz Anna, Serratosa Ines, García Marta, Masuet-Aumatell Cristina, Escobar Ignacio, Ramos Ricard
Department of Thoracic Surgery, Hospital Universitari de Bellvitge, Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, 08907 Barcelona, Spain.
Department of Thoracic Surgery, Hospital Clinic, 08036 Barcelona, Spain.
Cancers (Basel). 2023 Jun 30;15(13):3442. doi: 10.3390/cancers15133442.
Robotic-assisted thoracic surgery (RATS) is used increasingly frequently in major lung resection for early stage non-small-cell lung cancer (NSCLC) but has not yet been fully evaluated. The aim of this study was to compare the surgical outcomes of lymph node dissection (LND) performed via RATS with those from totally thoracoscopic (TT) four-port videothoracoscopy.
Clinical and pathological data were collected retrospectively from patients with clinical stage N0 NSCLC who underwent pulmonary resection in the form of lobectomy or segmental resection between June 2010 and November 2022. The assessment criteria were number of mediastinal lymph nodes and number of mediastinal stations dissected via the RATS approach compared with the four-port TT approach.
A total of 246 pulmonary resections with LND for clinical stages I-II NSCLC were performed: 85 via TT and 161 via RATS. The clinical characteristics of the patients were similar in both groups. The number of mediastinal nodes dissected and mediastinal stations dissected was significantly higher in the RATS group (TT: mean ± SD, 10.72 ± 3.7; RATS, 14.74 ± 6.3 [ < 0.001]), except in the inferior mediastinal stations. There was no difference in terms of postoperative complications.
In patients with early stage NSCLC undergoing major lung resection, the quality of hilomediastinal LND performed using RATS was superior to that performed using TT.
机器人辅助胸腔镜手术（RATS）在早期非小细胞肺癌（NSCLC）的主要肺切除术中使用越来越频繁，但尚未得到充分评估。本研究的目的是比较通过RATS进行的淋巴结清扫（LND）与完全胸腔镜（TT）四孔电视胸腔镜手术的手术结果。
回顾性收集2010年6月至2022年11月期间接受肺叶切除术或节段切除术形式的肺切除术的临床分期为N0的NSCLC患者的临床和病理数据。评估标准是通过RATS方法与四孔TT方法相比的纵隔淋巴结数量和清扫的纵隔站数。
共对246例临床I-II期NSCLC患者进行了LND肺切除术：85例通过TT进行，161例通过RATS进行。两组患者的临床特征相似。除下纵隔站外，RATS组清扫的纵隔淋巴结数量和纵隔站数明显更高（TT：平均值±标准差，10.72±3.7；RATS，14.74±6.3[<0.001]）。术后并发症方面无差异。
在接受主要肺切除术的早期NSCLC患者中，使用RATS进行肺门纵隔LND的质量优于使用TT进行的。
