Long-term and short-term outcomes of robot- versus video-assisted anatomic lung resection in lung cancer: a systematic review and meta-analysis

Author:

Wu Han1,Jin Runsen1,Yang Su1,Park Bernard J2,Li Hecheng1ORCID

Affiliation:

1. Department of Thoracic Surgery, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China

2. Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA

Abstract

Abstract OBJECTIVES Minimally invasive thoracic surgery has evolved with the introduction of robotic platforms. This study aimed to compare the long-term and short-term outcomes of the robot-assisted thoracic surgery (RATS) and video-assisted thoracic surgery (VATS) for anatomic lung resection. METHODS We searched published studies that investigated RATS and VATS in anatomic lung resection. Long-term outcomes (disease-free survival and overall survival) and short-term outcomes (30-day mortality, postoperative complications, conversion rate to open surgery and lymph node upstaging) were extracted. The features were compared and tested as hazard ratios (HRs) and odds ratios (ORs) at a 95% confidence interval (CI). RESULTS Twenty-five studies with 50 404 patients (7135 for RATS and 43 269 for VATS) were included. The RATS group had a longer disease-free survival than the VATS group (HR: 0.76; 95% CI: 0.59–0.97; P = 0.03), and the overall survival showed a similar trend but was not statistically significant (HR: 0.77; 95% CI: 0.57–1.05; P = 0.10). The RATS group showed a significantly lower 30-day mortality (OR: 0.55; 95% CI: 0.38–0.81; P = 0.002). No significant difference was found in postoperative complications (OR: 1.01; 95% CI: 0.87–1.16; P = 0.94), the conversion rate to open surgery (OR: 0.92; 95% CI: 0.56–1.52; P = 0.75) and lymph node upstaging (OR: 0.89; 95% CI: 0.52–1.54; P = 0.68). CONCLUSIONS RATS has comparable short-term outcomes and potential long-term survival benefits for anatomic lung resection compared with VATS.

Funder

Shanghai Municipal Education Commission—Gaofeng Clinical Medicine

Publisher

Oxford University Press (OUP)

Subject

Cardiology and Cardiovascular Medicine,Pulmonary and Respiratory Medicine,General Medicine,Surgery

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