Robotic thoracic surgery results in shorter hospital stay and lower postoperative pain compared to open thoracotomy: a matched pairs analysis

Surg Endosc. 2017 Oct;31(10):4126-4130. doi: 10.1007/s00464-017-5464-6. Epub 2017 Mar 8.


Background: To evaluate postoperative pain intensity and length of hospital stay after open or robotic thoracic surgery in a standardized postoperative pain therapy setting.

Methods: In the present retrospective (oberservation period: January 2015 until January 2016) study we matched data of 38 patients with robotic thoracic surgery ("robotic patients"; age: 62.2 years, male gender: 42.1%) with 38 patients with open thoracic surgery ("open patients"; age: 62.5 years, male gender: 42.1%). Power analysis indicated that 36 patients per group would be required.

Results: 68% of all patients received an epidural catheter, and 32% a systemic opioid based analgesia. Postoperative pain intensity in "robotic patients" was lower at rest on postoperative day 3-5 compared to "open patients" (NRS POD 3 robotic surgery 0.5±1.0 vs. open surgery 1.0±1.6, p = 0.04; NRS POD 4 robotic surgery 0,5 ± 1.0 vs. open surgery 1.1±1.3, p=0.04; NRS POD 5 robotic surgery 0.7 ± 1.0 vs. open surgery 1.5±1.5, p=0.003). Chest tube duration was shorter in "robotic patients" (2.9 ± 2.0 days vs. 4.9 ± 2.2 days; p < 0.001). Moreover, length of hospital stay was shorter in "robotic patients" than in "open patients" (6.9 days vs. 8.0 days; p = 0.02). There was no significant difference in postoperative opioid consumption between the groups. Nearly 95% of patients were discharged home with an oral opioid in both groups.

Conclusion: Patients after robotic pulmonary resection experience lower postoperative pain and are discharged earlier from hospital than patients after open thoracic surgery.

Study limitations: The study design is retrospectively.

Keywords: Controlled-release oxycodone; Epidural analgesia; Hospital stay; Open thoracotomy; Pain scores; Postoperative analgesia; Robotic pulmonary resection.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Analgesia, Epidural*
  • Analgesics, Opioid / therapeutic use*
  • Chest Tubes
  • Female
  • Humans
  • Length of Stay / statistics & numerical data*
  • Lung Neoplasms / surgery*
  • Male
  • Matched-Pair Analysis
  • Middle Aged
  • Pain Management
  • Pain, Postoperative / drug therapy*
  • Pneumonectomy / methods*
  • Postoperative Period
  • Retrospective Studies
  • Robotic Surgical Procedures / methods*
  • Thoracic Surgery, Video-Assisted / methods*
  • Thoracoscopy / methods
  • Thoracotomy / methods*


  • Analgesics, Opioid