The experience of 389 cases of robotic assisted lobectomy for the treatment of non-small cell lung cancer

Abstract

Objective To analyze the perioperative parameters of non-small cell lung cancer patients who underwent robotic assisted lobectomy and summarize the surgical experience. Methods Retrospective review was conducted on 389 consecutive patients who underwent robotic-assisted lobectomy for clinical stage Ⅰ to Ⅲa of non-small cell lung cancer at Shanghai lung Tumor Clinical Medical Center, Shanghai Chest Hospital between May 2013 and December 2016. The maximum diameter of tumor on preoperative chest CT scan was(1.3±0.6)cm; 153 cases were in clinical stage Ⅰa, 148 in Ⅰb, 32 in Ⅰc, 6 in Ⅱb, 30 in Ⅲa; and the position of lesions for 37 cases was in left upper lobe, 101 in left lower lobe, 105 in right upper lobe, 32 in right middle lobe, 114 in right lower lobe; there were 380 cases of adenocarcinoma , and 9 cases of squamous carcinoma. Perioperative parameters and total hospital cost were analyzed. Results The average operative time of all 389 RATS lobectomy was(91.5±30.8)min; 95.8 % of patients’ estimated intraoperative blood loss were less than 100 ml; the conversion rate was 1.2% (4 cases); no patient received blood transfusion and no 30-day postoperative mortality occurred. All patients underwent systematic lymphadenectomy, and the average station and number of lymph nodes dissected were(5.7±1.5)and (9.8±3.4)respectively. The mean volume of chest tube drainage on the first postoperative day was(231.4±141.9)ml; the drainage period was (4.0±1.5)d and no patient was discharged with chest tube; the average postoperative hospital stay was(5.0±1.5)d; postoperative air leak was the primary complication, accounting for 9.0%. The mean total hospital costs (self pay + insurance coverage) was(93 809.23±13 371.26)Yuan. Conclusions Da Vinci surgical robotic system is safe and effective for the treatment of operable NSCLC, and it can overcome many disadvantages of traditional VATS. Key words: Non-small cell lung cancer; Da Vinci surgical robotic system; Operative time; Hospital cost