Short-term and mid-term survival in bronchial sleeve resection by robotic system versus thoracotomy for centrally located lung cancer

Eur J Cardiothorac Surg. 2018 Mar 1;53(3):648-655. doi: 10.1093/ejcts/ezx355.

Abstract

Objectives: The aim of this study was to compare the short-term and mid-term results of patients with centrally located lung cancer who underwent bronchial sleeve resection by robotic system or thoracotomy.

Methods: From September 2014 to September 2015, 103 patients, including 17 robotic and 86 open cases, were included in our study. All the clinicopathological data, operative details and follow-up information were investigated.

Results: There were no intraoperative deaths. The mean console time was 113.59 min. The operative time for robotic surgery (155.06 ± 44.75 min), even in our initial cases, was comparable to that for thoracotomy (150.30 ± 47.84 min, P = 0.71). The 30-day mortality rate in the robotic and thoracotomy groups was 1 (6%) patient and 2 (2%) patients, respectively, with no significant difference (P = 0.43). A total of 4 (24%) patients in the robotic group and 22 (26%) patients in the thoracotomy group experienced postoperative complications (P = 0.86). In multivariable analysis, tumour size and postoperative radiotherapy were significant predictors of relapse-free survival, whereas only the intensive care unit stay was a significant predictor of overall survival. There was no significant difference in relapse-free survival (log-rank P = 0.16) and overall survival (log-rank P = 0.59) between the 2 groups.

Conclusions: Robotic surgery for bronchial sleeve resection is safe and feasible and has similar oncological outcomes compared with open procedures. But long-term survival still needs to be investigated.

MeSH terms

  • Aged
  • Female
  • Humans
  • Lung / surgery
  • Lung Neoplasms* / mortality
  • Lung Neoplasms* / surgery
  • Male
  • Middle Aged
  • Pneumonectomy* / methods
  • Pneumonectomy* / mortality
  • Postoperative Complications
  • Retrospective Studies
  • Robotic Surgical Procedures / mortality*
  • Thoracic Surgery, Video-Assisted / mortality*