Robot-Assisted Thoracic Surgery for Lung Lobectomy in NSCLC
By: Meg Barbor, MPH
Posted: Wednesday, August 2, 2017
In patients with non–small cell lung cancer (NSCLC), lung lobectomy with robot-assisted thoracic surgery seems to be a safe and feasible alternative to video-assisted thoracic surgery and may achieve equivalent short-term surgical efficacy, according to research published by Shiyou Wei, MD, of the Department of Thoracic Surgery, West China Hospital, Sichuan University, and colleagues, in the World Journal of Surgical Oncology.
An analysis of 12 retrospective cohort studies showed robot-assisted lobectomy significantly reduced the mortality rate when compared with video-assisted lobectomy (relative risk = 0.54), but this was not consistent with the pooled result of 6 matched studies (relative risk = 0.12), the investigators reported. There was no significant difference in morbidity between the two approaches.
Lobectomy is considered the standard therapy for patients with early-stage NSCLC, and a minimally invasive approach such as video-assisted surgery is generally recommended. Despite the advantages of video-assisted surgery—superior perioperative outcomes and improved long-term survival over thoracotomy—the procedure has shortcomings, such as a steep learning curve and difficult hand-eye coordination.
Robot-assisted lung lobectomy is a relatively new technique, offering similar advantages as video-assisted surgery, but the robotic technique may be limited by its longer operative times and higher hospital costs. Additionally, the long-term efficacy of robot-assisted surgery remains to be seen.