Outcomes and quality of life after Robot-assisted lobectomy/segmentectomy for lung cancer compared to video-assisted thoracoscopic surgery: both three-port procedures performed by a single surgeon

Liang Zheng; Peng Song; Yanru Jiang; Xiao Fan; Chen Yang; Lei Zhang; Qianyun Wang

doi:10.21037/jtd-22-238

Outcomes and quality of life after Robot-assisted lobectomy/segmentectomy for lung cancer compared to video-assisted thoracoscopic surgery: both three-port procedures performed by a single surgeon

J Thorac Dis. 2022 Mar;14(3):689-698. doi: 10.21037/jtd-22-238.

Authors

Liang Zheng¹, Peng Song¹, Yanru Jiang¹, Xiao Fan¹, Chen Yang¹, Lei Zhang¹, Qianyun Wang¹

Affiliation

¹ Department of Thoracic Surgery, The First People's Hospital of Changzhou and The Third Affiliated Hospital of Soochow University, Changzhou, China.

Abstract

Background: At present, research comparing robot-assisted thoracic surgery (RATS) and video-assisted thoracoscopic surgery (VATS) in lobectomy/segmentectomy for lung cancer is insufficient. This paper aimed to compare the safety, short-term efficacy, quality of life (QoL), and delayed complications at 6 weeks postoperatively via a retrospectively controlled study by a single surgeon.

Methods: A total of 110 non-small cell lung cancer (NSCLC) cases from December 2020 to May 2021 were enrolled in this retrospective study, and were divided into RATS and VATS groups (both three-port procedures) according to the patients' preference. The propensity-score matching method was applied to control the potential differences. The patients were treated with lobectomy/segmentectomy for lung cancer by RATS or VATS, and the safety outcomes were evaluated. The follow-up was initiated after surgery, and the outcome assessments including hospitalization costs, short-term efficacy, pain and QoL, were collected and analyzed.

Results: Both matched groups achieved a R0 resection rate of 100%. The average operation time of the RATS group was 21 minutes shorter than VATS (P<0.01), and the average hospitalization costs of the RATS group was 17,746 China Yuan higher than VATS (P<0.01). Furthermore, the visual analogue pain scores of the RATS group were lower than those of the VATS group at 1 day and 6 weeks postoperatively (2.53±0.86 vs. 3.88±0.88 and 0.35±0.65 vs. 0.74±0.88, respectively, P<0.05). Moreover, the core QoL scale score for cancer patients in the RATS group were higher than those of the VATS group at 6 weeks postoperatively (98.64±5.73 vs. 93.02±15.21, respectively, P<0.05). No significant differences were observed in the other indicators.

Conclusions: Despite its high cost, RATS showed considerable potential for reducing the operation time and improving the QoL of patients. Meanwhile, RATS and VATS exhibited similar perioperative safety and short-term efficacy in lobectomy and segmentectomy.

Keywords: Quality of life (QoL); lung cancer; robot-assisted thoracic surgery (RATS).