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Robotic- Versus Video-assisted Thoracic Surgery In Lung Resections For Pulmonary Neoplasm: A Single-institution Analysis
Celsa M. Tonelli, Kostaninos Poulikidas, James Lubawski, Amber Yow, Emily Saha, Suzanne Baldwin, Wickii T. Vigneswaran
Loyola University Medical Center, Maywood, IL, USA
Background: Robotic-assisted thoracic surgery outcomes remain controversial when compared to Video-assisted thoracic surgery (VATS). We compared the outcomes between the two surgical modalities by equalizing preoperative and postoperative care to determine if there were significant differences in outcomes.
Methods: A retrospective review of patients who underwent lung resection for benign or malignant neoplasm at a single academic center was performed, with comparison between robotic and VATS techniques. All surgeons had performed greater than two hundred cases in the selected modality. Patient characteristics were compared using the Student t test and Pearson χ2. Complications and outcomes were analyzed using the Student t test and Pearson χ2, and were risk-adjusted using a logistic regression.
Results: A total of 237 patients underwent lung resections for neoplasm (VATS = 110, robot = 127) at our institution over 24 months. There were no significant differences amongst the two groups in relation to age (p = 0.169), race (p = 0.193), gender (p = 0.187), BMI (p = 0.189), or smoking status (p = 0.103). The length of procedure (p = 0.75) or time spent in the operating room (p = 0.97) were similar. Patients who underwent robotic-assisted surgery had no increase in postoperative events (p = 0.47), however did experience lower rates of postoperative atrial arrhythmias compared to the VATS patients (p = 0.01).
Conclusions: Robotic surgery is an acceptable modality for lung resections. In comparing a single institution, we were able to equalize postoperative and preoperative care. Whether the robotic procedure offers any advantages over VATS is unclear and will require further investigation in a larger cohort.
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