Initial perioperative outcomes of robot-assisted thoracoscopic lobectomy using a confronting setting
Tóm tắt
Most robot-assisted thoracoscopic surgery (RATS) is performed from the vertical view. This study evaluates the initial outcomes of our novel confronting RATS technique, in which the patient was viewed horizontally, as in open thoracotomy. We reviewed data on patients who underwent thoracoscopic lobectomy between January, 2019 and April, 2022. Perioperative outcomes were compared between RATS and video-assisted thoracoscopic surgery (VATS), using propensity-score matching. RATS and VATS were performed for 83 and 571 patients, respectively. After propensity-score matching, data on 81 patients from each of the two groups were retrieved. The operative time was significantly longer for RATS than for VATS (199 ± 44 min vs. 173 ± 37 min, p < 0.001). There was no mortality or conversion to thoracotomy in either of the groups. The rates of overall complications and prolonged air leak did not differ significantly between the groups. The serum creatine phosphokinase level on postoperative day 4 was higher after RATS than after VATS. The number of resected lymph nodes and the rates of nodal upstaging did not differ significantly between the groups. The initial perioperative outcomes of RATS using the confronting settings were comparable to those of VATS.
Tài liệu tham khảo
Melfi FM, Menconi GF, Mariani AM, Angeletti CA. Early experience with robotic technology for thoracoscopic surgery. Eur J Cardiothorac Surg. 2002;21:864–8.
Haruki T, Takagi Y, Kubouchi Y, Kidokoro Y, Nakanishi A, Nozaka Y, et al. Comparison between robot-assisted thoracoscopic surgery and video-assisted thoracoscopic surgery for mediastinal and hilar lymph node dissection in lung cancer surgery. Interact Cardiovasc Thorac Surg. 2021;33:409–17.
Veronesi G, Novellis P, Voulaz E, Alloisio M. Robot-assisted surgery for lung cancer: state of the art and perspectives. Lung Cancer. 2016;101:28–34.
Ichinose J, Kohno T, Fujimori S, Mun M. Locoregional control of thoracoscopic lobectomy with selective lymphadenectomy for lung cancer. Ann Thorac Surg. 2010;90:235–9.
Mun M, Ichinose J, Matsuura Y, Nakao M, Okumura S. Video-assisted thoracoscopic surgery lobectomy via confronting upside-down monitor setting. J Vis Surg. 2017;3:129.
Park BJ, Flores RM, Rusch VW. Robotic assistance for video-assisted thoracic surgical lobectomy: technique and initial results. J Thorac Cardiovasc Surg. 2006;131:54–9.
Veronesi G, Galetta D, Maisonneuve P, Melfi F, Schmid RA, Borri A, et al. Four-arm robotic lobectomy for the treatment of early-stage lung cancer. J Thorac Cardiovasc Surg. 2010;140:19–25.
Cerfolio RJ, Bryant AS, Minnich DJ. Starting a robotic program in general thoracic surgery: why, how, and lessons learned. Ann Thorac Surg. 2011;91:1729–36 (discussion 1727–36).
Dylewski MR, Ohaeto AC, Pereira JF. Pulmonary resection using a total endoscopic robotic video-assisted approach. Semin Thorac Cardiovasc Surg. 2011;23:36–42.
Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004;240:205–13.
Mun M, Nakao M, Matsuura Y, Ichinose J, Okumura S. Oncological outcomes after lobe-specific mediastinal lymph node dissection via multiport video-assisted thoracoscopic surgery. Eur J Cardiothorac Surg. 2020;58:i92–9.
Ichinose J, Matsuura Y, Nakao M, Mun M. A novel procedure of thoracoscopic 4L lymph node dissection: 4L posterior first technique. J Vis Surg. 2020;6:11.
Funai K, Kawase A, Mizuno K, Koyama S, Takanashi Y, Shiiya N. Uniquely modified robotic-assisted thoracic surgery with good intrathoracic visual field. Ann Thorac Surg. 2020;110:e435–6.
Yamazaki K, Toyokawa G, Kozuma Y, Shoji F, Shimokawa M, Takeo S. Cumulative experience of the anterior approach in robot-assisted thoracic surgery for lung cancer patients. J Thorac Dis. 2021;13:5487–95.
Sakakura N, Nakada T, Shirai S, Takahara H, Nakanishi K, Matsui T, et al. Robotic open-thoracotomy-view approach using vertical port placement and confronting monitor setting. Interact Cardiovasc Thorac Surg. 2021;33:60–7.