Early outcomes of robotic versus thoracoscopic segmentectomy for early-stage lung cancer: A multi-institutional propensity score-matched analysis
Anatomical segmentectomy via robotic thoracic surgery and video-assisted thoracic surgery (VATS) are minimally invasive surgical approaches for treatment of early-stage non–small cell lung cancer (NSCLC). However, few research studies have compared early outcomes. A retrospective analysis was made o...
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| Veröffentlicht in: | The Journal of thoracic and cardiovascular surgery 2020-11, Vol.160 (5), p.1363-1372 |
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| creator | Zhang, Yajie Chen, Chun Hu, Jian Han, Yu Huang, Maosheng Xiang, Jie Li, Hecheng |
| description | Anatomical segmentectomy via robotic thoracic surgery and video-assisted thoracic surgery (VATS) are minimally invasive surgical approaches for treatment of early-stage non–small cell lung cancer (NSCLC). However, few research studies have compared early outcomes.
A retrospective analysis was made of 774 patients, 298 who received robotic and 476 who received VATS, who underwent minimally invasive segmentectomy for early-stage NSCLC at 3 academic institutions between June 2015 and August 2019. Perioperative outcomes were compared after propensity score-matching on the basis of age, gender, body mass index, percent forced expiratory volume in 1 second, smoking status, American Society of Anesthesiologists score, type of segmentectomy, tumor size, and institution.
There were 257 patients in each group after propensity score-matching. The baseline characteristics and type of segmentectomy were comparable. Three conversions to thoracotomy occurred in the VATS group, and 1 in the robotic group (P = .624). There was no significant difference in operative time (147.91 ± 52.42 vs 149.23 ± 49.66 minutes; P = .773), blood loss (50 mL [interquartile range (IQR), 50-100 mL] vs 100 mL [IQR, 30-100 mL]; P = .177), rates of overall complications (17.9 vs 14.8%; P = .340), and length of stay (4 days [IQR, 3-5 days] vs 4 days [IQR, 3-5 days]; P = .417) between the robotic and VATS groups, respectively. Robotic segmentectomy was more costly ($12,019.30 ± 1678.30 vs $7834.80 ± 1291.20; P |
| doi_str_mv | 10.1016/j.jtcvs.2019.12.112 |
| format | Article |
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A retrospective analysis was made of 774 patients, 298 who received robotic and 476 who received VATS, who underwent minimally invasive segmentectomy for early-stage NSCLC at 3 academic institutions between June 2015 and August 2019. Perioperative outcomes were compared after propensity score-matching on the basis of age, gender, body mass index, percent forced expiratory volume in 1 second, smoking status, American Society of Anesthesiologists score, type of segmentectomy, tumor size, and institution.
There were 257 patients in each group after propensity score-matching. The baseline characteristics and type of segmentectomy were comparable. Three conversions to thoracotomy occurred in the VATS group, and 1 in the robotic group (P = .624). There was no significant difference in operative time (147.91 ± 52.42 vs 149.23 ± 49.66 minutes; P = .773), blood loss (50 mL [interquartile range (IQR), 50-100 mL] vs 100 mL [IQR, 30-100 mL]; P = .177), rates of overall complications (17.9 vs 14.8%; P = .340), and length of stay (4 days [IQR, 3-5 days] vs 4 days [IQR, 3-5 days]; P = .417) between the robotic and VATS groups, respectively. Robotic segmentectomy was more costly ($12,019.30 ± 1678.30 vs $7834.80 ± 1291.20; P < .001) because of the amortization and consumables of the robotic system. There were a greater number of N1 lymph nodes and N1 stations in the robotic group.
Segmentectomy with robotic and VATS are safe and feasible for early-stage NSCLC treatment. A robotic approach might lead to a better N1 lymph node dissection.</description><identifier>ISSN: 0022-5223</identifier><identifier>EISSN: 1097-685X</identifier><identifier>DOI: 10.1016/j.jtcvs.2019.12.112</identifier><identifier>PMID: 32113718</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Carcinoma, Non-Small-Cell Lung - diagnosis ; Carcinoma, Non-Small-Cell Lung - surgery ; Female ; Follow-Up Studies ; Humans ; Lung Neoplasms - diagnosis ; Lung Neoplasms - surgery ; Male ; Middle Aged ; Neoplasm Staging ; Operative Time ; Pneumonectomy - methods ; Propensity Score ; propensity score matching ; Retrospective Studies ; robotic ; Robotic Surgical Procedures - methods ; segmentectomy ; Thoracotomy - methods ; Time Factors ; Treatment Outcome ; video-assisted thoracic surgery</subject><ispartof>The Journal of thoracic and cardiovascular surgery, 2020-11, Vol.160 (5), p.1363-1372</ispartof><rights>2020 The American Association for Thoracic Surgery</rights><rights>Copyright © 2020 The American Association for Thoracic Surgery. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c470t-190f1942511e1b9e9455fe614b9cc36783015c48c575c21d449e49d87de27e103</citedby><cites>FETCH-LOGICAL-c470t-190f1942511e1b9e9455fe614b9cc36783015c48c575c21d449e49d87de27e103</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0022522320302269$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32113718$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Zhang, Yajie</creatorcontrib><creatorcontrib>Chen, Chun</creatorcontrib><creatorcontrib>Hu, Jian</creatorcontrib><creatorcontrib>Han, Yu</creatorcontrib><creatorcontrib>Huang, Maosheng</creatorcontrib><creatorcontrib>Xiang, Jie</creatorcontrib><creatorcontrib>Li, Hecheng</creatorcontrib><title>Early outcomes of robotic versus thoracoscopic segmentectomy for early-stage lung cancer: A multi-institutional propensity score-matched analysis</title><title>The Journal of thoracic and cardiovascular surgery</title><addtitle>J Thorac Cardiovasc Surg</addtitle><description>Anatomical segmentectomy via robotic thoracic surgery and video-assisted thoracic surgery (VATS) are minimally invasive surgical approaches for treatment of early-stage non–small cell lung cancer (NSCLC). However, few research studies have compared early outcomes.
A retrospective analysis was made of 774 patients, 298 who received robotic and 476 who received VATS, who underwent minimally invasive segmentectomy for early-stage NSCLC at 3 academic institutions between June 2015 and August 2019. Perioperative outcomes were compared after propensity score-matching on the basis of age, gender, body mass index, percent forced expiratory volume in 1 second, smoking status, American Society of Anesthesiologists score, type of segmentectomy, tumor size, and institution.
There were 257 patients in each group after propensity score-matching. The baseline characteristics and type of segmentectomy were comparable. Three conversions to thoracotomy occurred in the VATS group, and 1 in the robotic group (P = .624). There was no significant difference in operative time (147.91 ± 52.42 vs 149.23 ± 49.66 minutes; P = .773), blood loss (50 mL [interquartile range (IQR), 50-100 mL] vs 100 mL [IQR, 30-100 mL]; P = .177), rates of overall complications (17.9 vs 14.8%; P = .340), and length of stay (4 days [IQR, 3-5 days] vs 4 days [IQR, 3-5 days]; P = .417) between the robotic and VATS groups, respectively. Robotic segmentectomy was more costly ($12,019.30 ± 1678.30 vs $7834.80 ± 1291.20; P < .001) because of the amortization and consumables of the robotic system. There were a greater number of N1 lymph nodes and N1 stations in the robotic group.
Segmentectomy with robotic and VATS are safe and feasible for early-stage NSCLC treatment. A robotic approach might lead to a better N1 lymph node dissection.</description><subject>Carcinoma, Non-Small-Cell Lung - diagnosis</subject><subject>Carcinoma, Non-Small-Cell Lung - surgery</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Lung Neoplasms - diagnosis</subject><subject>Lung Neoplasms - surgery</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Neoplasm Staging</subject><subject>Operative Time</subject><subject>Pneumonectomy - methods</subject><subject>Propensity Score</subject><subject>propensity score matching</subject><subject>Retrospective Studies</subject><subject>robotic</subject><subject>Robotic Surgical Procedures - methods</subject><subject>segmentectomy</subject><subject>Thoracotomy - methods</subject><subject>Time Factors</subject><subject>Treatment Outcome</subject><subject>video-assisted thoracic surgery</subject><issn>0022-5223</issn><issn>1097-685X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kc9u1DAQxi0EokvhCZCQj1wSPI7zx0gcqqoFpEpcqNSb5XUmW6-SePE4K-UxeGO83cKR00ie33wz_j7G3oMoQUDzaV_ukztSKQXoEmQJIF-wDQjdFk1XP7xkGyGkLGopqwv2hmgvhGgz-5pdVBKgaqHbsN83No4rD0tyYULiYeAxbEPyjh8x0kI8PYZoXSAXDvmRcDfhnNClMK18CJHjSaCgZHfIx2XecWdnh_Ezv-LTMiZf-JmST0vyYbYjP8RwwJl8WnmWjFhMNrlH7LnN3ZU8vWWvBjsSvnuul-z-9ubn9bfi7sfX79dXd4VTrUgFaDGAVrIGQNhq1KquB2xAbbVzVdN2lYDaqc7Vbe0k9EppVLrv2h5liyCqS_bxrJsv-rUgJTN5cjiOdsawkJFVo7tOSq0yWp1RFwNRxMEcop9sXA0Ic8rC7M1TFuaUhQFpchZ56sPzgmU7Yf9v5q_5GfhyBjB_8-gxGnIes3m9j9lg0wf_3wV_ACpynz4</recordid><startdate>202011</startdate><enddate>202011</enddate><creator>Zhang, Yajie</creator><creator>Chen, Chun</creator><creator>Hu, Jian</creator><creator>Han, Yu</creator><creator>Huang, Maosheng</creator><creator>Xiang, Jie</creator><creator>Li, Hecheng</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>202011</creationdate><title>Early outcomes of robotic versus thoracoscopic segmentectomy for early-stage lung cancer: A multi-institutional propensity score-matched analysis</title><author>Zhang, Yajie ; Chen, Chun ; Hu, Jian ; Han, Yu ; Huang, Maosheng ; Xiang, Jie ; Li, Hecheng</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c470t-190f1942511e1b9e9455fe614b9cc36783015c48c575c21d449e49d87de27e103</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Carcinoma, Non-Small-Cell Lung - diagnosis</topic><topic>Carcinoma, Non-Small-Cell Lung - surgery</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>Lung Neoplasms - diagnosis</topic><topic>Lung Neoplasms - surgery</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Neoplasm Staging</topic><topic>Operative Time</topic><topic>Pneumonectomy - methods</topic><topic>Propensity Score</topic><topic>propensity score matching</topic><topic>Retrospective Studies</topic><topic>robotic</topic><topic>Robotic Surgical Procedures - methods</topic><topic>segmentectomy</topic><topic>Thoracotomy - methods</topic><topic>Time Factors</topic><topic>Treatment Outcome</topic><topic>video-assisted thoracic surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Zhang, Yajie</creatorcontrib><creatorcontrib>Chen, Chun</creatorcontrib><creatorcontrib>Hu, Jian</creatorcontrib><creatorcontrib>Han, Yu</creatorcontrib><creatorcontrib>Huang, Maosheng</creatorcontrib><creatorcontrib>Xiang, Jie</creatorcontrib><creatorcontrib>Li, Hecheng</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The Journal of thoracic and cardiovascular surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Zhang, Yajie</au><au>Chen, Chun</au><au>Hu, Jian</au><au>Han, Yu</au><au>Huang, Maosheng</au><au>Xiang, Jie</au><au>Li, Hecheng</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Early outcomes of robotic versus thoracoscopic segmentectomy for early-stage lung cancer: A multi-institutional propensity score-matched analysis</atitle><jtitle>The Journal of thoracic and cardiovascular surgery</jtitle><addtitle>J Thorac Cardiovasc Surg</addtitle><date>2020-11</date><risdate>2020</risdate><volume>160</volume><issue>5</issue><spage>1363</spage><epage>1372</epage><pages>1363-1372</pages><issn>0022-5223</issn><eissn>1097-685X</eissn><abstract>Anatomical segmentectomy via robotic thoracic surgery and video-assisted thoracic surgery (VATS) are minimally invasive surgical approaches for treatment of early-stage non–small cell lung cancer (NSCLC). However, few research studies have compared early outcomes.
A retrospective analysis was made of 774 patients, 298 who received robotic and 476 who received VATS, who underwent minimally invasive segmentectomy for early-stage NSCLC at 3 academic institutions between June 2015 and August 2019. Perioperative outcomes were compared after propensity score-matching on the basis of age, gender, body mass index, percent forced expiratory volume in 1 second, smoking status, American Society of Anesthesiologists score, type of segmentectomy, tumor size, and institution.
There were 257 patients in each group after propensity score-matching. The baseline characteristics and type of segmentectomy were comparable. Three conversions to thoracotomy occurred in the VATS group, and 1 in the robotic group (P = .624). There was no significant difference in operative time (147.91 ± 52.42 vs 149.23 ± 49.66 minutes; P = .773), blood loss (50 mL [interquartile range (IQR), 50-100 mL] vs 100 mL [IQR, 30-100 mL]; P = .177), rates of overall complications (17.9 vs 14.8%; P = .340), and length of stay (4 days [IQR, 3-5 days] vs 4 days [IQR, 3-5 days]; P = .417) between the robotic and VATS groups, respectively. Robotic segmentectomy was more costly ($12,019.30 ± 1678.30 vs $7834.80 ± 1291.20; P < .001) because of the amortization and consumables of the robotic system. There were a greater number of N1 lymph nodes and N1 stations in the robotic group.
Segmentectomy with robotic and VATS are safe and feasible for early-stage NSCLC treatment. A robotic approach might lead to a better N1 lymph node dissection.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>32113718</pmid><doi>10.1016/j.jtcvs.2019.12.112</doi><tpages>10</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Carcinoma, Non-Small-Cell Lung - diagnosis Carcinoma, Non-Small-Cell Lung - surgery Female Follow-Up Studies Humans Lung Neoplasms - diagnosis Lung Neoplasms - surgery Male Middle Aged Neoplasm Staging Operative Time Pneumonectomy - methods Propensity Score propensity score matching Retrospective Studies robotic Robotic Surgical Procedures - methods segmentectomy Thoracotomy - methods Time Factors Treatment Outcome video-assisted thoracic surgery |
| title | Early outcomes of robotic versus thoracoscopic segmentectomy for early-stage lung cancer: A multi-institutional propensity score-matched analysis |
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