Comparative short-term outcomes of robotic-assisted surgery for older patients with non-small cell lung cancer: a propensity matched study

Updates Surg. 2022 Jun;74(3):1087-1096. doi: 10.1007/s13304-021-00992-x. Epub 2021 Feb 4.

Abstract

To investigate comparative short-term outcomes of robotic-assisted surgery (RAS) versus video-assisted thoracoscopic surgery (VATS) for older non-small cell lung cancer (NSCLC) patients. Patients ≥ 65 years old with stage I-III NSCLC operated with RAS or VATS from 2016 to 2018 were consecutively included. Propensity score-matched (PSM) method was implemented to balance inter-group biases. Totally 376 participants (224 with VATS and 152 with RAS) were included. After PSM, a cohort (144 with VATS and 107 with RAS) was generated with balanced baseline characteristics. RAS was significantly superior over VATS in the majority of perioperative outcomes, such as operating time (120.8 vs. 165.1 min), conversion rate (0.0% vs. 19.4%), and length of stay (8.6 vs. 10.8 days). RAS versus VATS was significantly associated with comparable rates of postoperative complications (OR 0.642, 95% CI 0.311-1.327), except the rate of pneumonia (OR 0.161, 95% CI 0.048-0.544). RAS leads to analogous postoperative complications and seemingly accelerates the recovery time of older NSCLC patients compared with VATS.

Keywords: Non-small cell lung cancer; Older patients; Outcomes; Robotic-assisted surgery; Video-assisted thoracoscopic surgery.

MeSH terms

  • Aged
  • Carcinoma, Non-Small-Cell Lung* / surgery
  • Humans
  • Length of Stay
  • Lung Neoplasms* / surgery
  • Pneumonectomy / methods
  • Postoperative Complications / etiology
  • Retrospective Studies
  • Robotic Surgical Procedures* / adverse effects
  • Thoracic Surgery, Video-Assisted / adverse effects
  • Thoracic Surgery, Video-Assisted / methods