Abstract

Robotic surgery for lung cancer has not widely spread because of the lack of definitive advantage compared to conventional approaches, specifically video-assisted thoracic surgery (VATS). Some studies have reported that postoperative complication in robotic surgery is superior for unclear reasons. The aim of this study is to compare the perioperative outcomes, particularly pointing out postoperative complication among robotic, video-assisted thoracic surgery (VATS) and thoracotomy approach in non-small cell lung cancer (NSCLC). We performed a retrospective review of NSCLC patients who underwent curative anatomical resection in our hospital from January 2011 to April 2016. There were 346 lobectomy cases and 76 segmentectomy cases. The patients were classified into four groups (robotic, VATS, open conversion from VATS, and thoracotomy) and were compared for differences in perioperative outcomes. Total 422 patients (43 robotic, 265 VATS, 30 open conversion from VATS, and 84 thoracotomy) were included in the analysis. Clinical and pathological stage showed earlier in robotic and VATS cases. Operative time (min), bleeding amount (gram) and drainage period (days) for robot, VATS, conversion and thoracotomy were 247/20/2, 188/10/2, 246/100/2, 225/ 92.5/2 respectively (p<0.0001). In the incidence of all, over G3, respiratory over G3 postoperative complications robotic surgery showed significantly lowest among them and there were neither conversion to thoracotomy nor operative/hospital mortality in robotic surgery. In our initial results of robotic surgery, lower incidence of operative morbidities is one of the advantageous features. Important issue whether robotic surgery is established as a minimally invasive approach for NSCLC or not should be verified.

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