Highlights
- •R-VATS segmentectomy significantly preserves more pulmonary function than lobectomy.
- •R-VATS segmentectomy has a higher rate of pulmonary complications than lobectomy.
- •R-VATS segmentectomy is a viable and safe option for lung cancer patients.
Abstract
Background
Lobectomy is standard treatment for early-stage lung cancer, but sublobar resection
remains debated. We compared outcomes after robotic-assisted video-assisted thoracoscopic
(R-VATS) segmentectomy vs lobectomy.
Methods
We retrospectively analyzed data from 251 consecutive patients who underwent R-VATS
lobectomy (n = 208) or segmentectomy (n = 43) by a single surgeon over 36 months.
Pulmonary function tests and perioperative outcomes were compared using Chi-squared
test, unpaired Student t test, or Kruskal–Wallis test, with significance at P ≤ .05.
Results
Intraoperative complications were not significantly different, but median operative
times were longer for R-VATS segmentectomies (P < .01). Postoperative complications were not significantly different, except for
increased rates of pneumothorax after chest tube removal (P = .032) and of effusions or empyema (P = .011) after R-VATS segmentectomies. Predicted changes for forced expiratory volume
in 1 second and diffusion constant of the lung for carbon monoxide are significantly
less after R-VATS segmentectomy (P < .001).
Conclusions
R-VATS segmentectomy should be considered as an alternative to lobectomy for conserving
lung function in respiratory-compromised lung cancer patients, although oncologic
efficacy remains undetermined.
Keywords
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References
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Article info
Publication history
Published online: September 29, 2016
Received in revised form:
September 4,
2016
Received:
March 18,
2016
Footnotes
E.M.T. and J.P.F. have had financial relationships with Intuitive Surgical Corporation in form of honoraria as robotic thoracic surgery proctors and observation sites.
No other authors have any conflicts of interest or financial ties to disclose.
Identification
Copyright
© 2016 Elsevier Inc. All rights reserved.
