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Trends in segmentectomy for the treatment of stage 1A non-small cell lung cancers: Does the robot have an impact?

Published:October 26, 2022DOI:https://doi.org/10.1016/j.amjsurg.2022.10.016

      Highlights

      • The proportion of segmentectomies compared to lobectomies has greatly increased.
      • Segmentectomy was performed in older patients compared to the lobectomy group.
      • Patients receiving a MIS approach for segmentectomy significantly increased.
      • The proportion of robotic compared to VATS segmentectomies has greatly increased.
      • Robotic segmentectomies have increased in prevalence for stage 1A NSCLC.

      Abstract

      Objectives

      Lobectomy may unnecessarily resect healthy lung parenchyma in Stage 1A non-small cell lung cancers (NSCLC). Segmentectomies may provide a lung-sparing option. VATS segmentectomies can be technically challenging; robotics may have features that provide advantages in performing segmentectomies. We describe the association of the robot on national trends in segmentectomies.

      Methods

      The National Cancer Database (2010–2017) was queried for patients with Stage 1A NSCLC who underwent lobectomies and segmentectomies. The proportion of segmentectomies vs. lobectomies and the proportion of robotic vs. VATS segmentectomies was calculated annually.

      Results

      The proportion of segmentectomies increased compared to lobectomies for all surgical approaches but remained constant for minimally-invasive approaches. The proportion of robotic segmentectomies increased over the years compared to VATS segmentectomies.
      Descriptive statistics are reported as numbers and proportions. Trends in the proportions of lobectomies and segmentectomies were compared using Chi-squared test for categorical variables and unpaired t-test for independent means. A p-value of <0.05 was considered statistically significant. Statistical analysis was performed using SPSS Statistics Software version 24 (IBM Corp, Armonk, NY).

      Conclusions

      We demonstrate an increasing trend and proportion of robotic segmentectomies being performed in comparison to VATS segmentectomies. The robotic platform may facilitate the performance of more segmentectomies for early-stage NSCLC.Statistical Analysis

      Graphical abstract

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