P1.08-048 Comparison of Pulmonary Function after Robotic-Assisted Video-Thoracoscopic Lobectomies vs Segmentectomies

Abstract

Lobectomy is the standard surgical procedure for early stage lung cancer, but sub-lobar resection is being debated. We compared pulmonary function after robotic-assisted video-assisted Thoracoscopic (R-VATS) segmentectomy versus lobectomy; comparison using robotic instruments hasn't been published. We retrospectively analyzed prospectively collected data from 251 consecutive patients who underwent lobectomy (N=208) and segmentectomy (N=43) via R-VATS by one surgeon. Unpaired Student's t-test and Chi-square tests were used to determine statistical significance (p≤ 0.05). Majority of patients had no prior lung surgery. We used “Predicted (PFT)=Preop(PFT)x(1-(Segments x 0.0556))”, where 0.0556=1seg/18seg. For patients with prior resections, the number of segments previously resected was taken into account (1seg/(18-Prior resection). View Large Image Figure ViewerDownload Hi-res image Download (PPT) Preoperative FEV1(%) and DLCO(%) were statistically significant between the two groups. Also, FEV1 and DLCO were lower in segmentectomy patients. As expected, predicted changes between preoperative and postoperative values were significant. Predicted post-operative FEV1 and DLCO did not show any significant difference between the two groups. While pre-operative PFTs were significantly lower in segmentectomy patients compared to lobectomy patients, predicted post-operative PFTs do not differ significantly. Predicted changes for FEV1 and DLCO are significantly less in segmentectomy. Thus, negate the difference in pre-operative PFTs. In conclusion, R-VATS segmentectomy preserves lung function and may be considered a viable alternative