Agyabeng-Dadzie Kojo, Sarkaria Inderpal S, Chan Ernest, Christie Ian, Mazur Summer, Ruppert Kristine, Christie Neil, Awais Omar, Levy Ryan, Baker Nicholas, Dhupar Rajeev, Pennathur Arjun, Luketich James D, Schuchert Matthew
University of Pittsburgh Medical Center, PA, USA.
Innovations (Phila). 2025 May-Jun;20(3):265-271. doi: 10.1177/15569845251334361. Epub 2025 May 13.
Previous studies have evaluated the feasibility of robot-assisted thoracoscopic segmentectomy (RVATS) in comparison with video-assisted thoracoscopic segmentectomy (VATS). We report both short-term and long-term outcomes comparing RVATS and VATS at a single institution.
This is a retrospective propensity-matched cohort study reviewing RVATS and VATS for primary non-small cell lung cancer (NSCLC) performed from 2013 to 2021 at our institution; 1:2 propensity matching was performed.
There were 108 patients who underwent RVATS and 370 who underwent VATS for primary lung cancer. After propensity matching, we had 2 well-matched cohorts of 102 patients in the RVATS group and 204 in the VATS group. Our data showed no significant difference in 90-day mortality, 30-day hospital readmission rate, or median number of lymph nodes between the RVATS and VATS groups. There was also no significant difference in postoperative morbidity except for pleural effusion. RVATS had a significantly greater median number of lymph node stations harvested and longer operative time. Although both groups achieved R0 resections in all patients, RVATS showed a greater negative tumor margin distance compared with VATS. There was no significant difference in disease-free survival or overall survival between the 2 groups at 3 years.
In our experience, RVATS showed a greater number of lymph node stations harvested and greater negative tumor margin distance without compromising perioperative and oncological outcomes for segmentectomy performed for NSCLC.
以往的研究评估了机器人辅助胸腔镜肺段切除术（RVATS）与电视辅助胸腔镜肺段切除术（VATS）相比的可行性。我们报告了在单一机构中比较RVATS和VATS的短期和长期结果。
这是一项回顾性倾向匹配队列研究，回顾了2013年至2021年在我们机构对原发性非小细胞肺癌（NSCLC）进行的RVATS和VATS手术；进行了1:2的倾向匹配。
有108例患者接受了RVATS治疗原发性肺癌，370例接受了VATS治疗。倾向匹配后，我们在RVATS组有102例患者和VATS组有204例患者组成了两个匹配良好的队列。我们的数据显示，RVATS组和VATS组在90天死亡率、30天再入院率或淋巴结中位数方面没有显著差异。除胸腔积液外，术后发病率也没有显著差异。RVATS切除的淋巴结站中位数显著更多，手术时间更长。虽然两组所有患者均实现了R0切除，但与VATS相比，RVATS的肿瘤阴性切缘距离更大。两组在3年时的无病生存率或总生存率没有显著差异。
根据我们的经验，对于NSCLC进行的肺段切除术，RVATS切除的淋巴结站数量更多，肿瘤阴性切缘距离更大，且不影响围手术期和肿瘤学结果。
