Gonzalez-Rivas Diego, Gomes-da Silva de Rosenzweig Pablo, Arana Bolaños Luis Fernando, Pimienta Ibarra Adriana Simoneta, Walji Hasanali David, Santillan Dohetty Patricio, Zhao Jun, Li Chang, Bosinceanu Mugurel, Bolaños Morales Francina Valezka
Department of Thoracic Surgery and Minimally Invasive Thoracic Surgery Unit (UCTMI), Coruña University Hospital, Coruña, Spain.
Department of Cardio-Thoracic Surgery, University Hospitals Coventry and Warwickshire, Coventry, UK.
Transl Lung Cancer Res. 2025 Aug 31;14(8):3170-3182. doi: 10.21037/tlcr-2025-498. Epub 2025 Aug 13.
Sleeve lobectomy (SL) has evolved into the preferred surgical option for centrally located non-small cell lung cancer (NSCLC) and other complex thoracic tumors, offering superior functional and oncological outcomes compared to pneumonectomy. The recent advent of robotic-assisted thoracic surgery (RATS), including its uniportal approach (uRATS), has extended the feasibility of SL to minimally invasive approaches. The objective of this study is to present our experience with uRATS sleeve resections, highlighting five complex cases, involving four sleeve lobectomies and one tracheal resection, performed using two different robotic platforms (da Vinci and ShuRui). Additionally, we aim to provide an up-to-date review of SL as a treatment strategy for NSCLC and centrally located tumors.
We performed a narrative review covering publications from 2010 to 2025. The search was conducted across PubMed, EMBASE, and Scopus databases.
Although data on RATS SL remains limited, several publications have highlighted the potential benefits of this approach. Comparative studies evaluating different operative approaches for SL have shown that RATS offers advantages over both open and video-assisted thoracic surgery. uRATS SL represents a novel and evolving technique that combines technical precision with favorable perioperative outcomes. However, its adoption is often slow due to the inherent complexity and steep learning curve associated with the procedure.
uRATS SL carinal and tracheal reconstructions have emerged as promising treatment strategies for centrally located tumors. However, there remains an urgent need for further comparative studies assessing both short- and long-term outcomes, as well as evaluating oncologic outcomes and their impact on patients' quality of life.
袖式肺叶切除术（SL）已发展成为治疗中央型非小细胞肺癌（NSCLC）及其他复杂胸部肿瘤的首选手术方式，与全肺切除术相比，其功能和肿瘤学效果更佳。包括单孔入路（uRATS）在内的机器人辅助胸外科手术（RATS）的出现，将SL的可行性扩展至微创方法。本研究的目的是介绍我们开展uRATS袖式切除术的经验，重点介绍5例复杂病例，包括使用两种不同机器人平台（达芬奇和术锐）实施的4例袖式肺叶切除术和1例气管切除术。此外，我们旨在对SL作为NSCLC和中央型肿瘤的治疗策略进行最新综述。
我们进行了一项叙述性综述，涵盖2010年至2025年的出版物。检索在PubMed、EMBASE和Scopus数据库中进行。
尽管关于RATS SL的数据仍然有限，但一些出版物强调了这种方法的潜在益处。评估SL不同手术方法的比较研究表明，RATS比开放手术和电视辅助胸外科手术都更具优势。uRATS SL是一种新颖且不断发展的技术，它将技术精准性与良好的围手术期效果相结合。然而，由于该手术固有的复杂性和陡峭的学习曲线，其应用往往较为缓慢。
uRATS SL隆突和气管重建已成为治疗中央型肿瘤的有前景的治疗策略。然而，迫切需要进一步开展比较研究，评估短期和长期结果，以及评估肿瘤学结果及其对患者生活质量的影响。
