WCLC 2025 - Posters & ePosters-EP.07.11 Comparison of Robotic Assisted Thoracoscopic Lobectomy and Video-Assisted Thoracoscopic Lobectomy for Early Stage Non-Small Cell Lung Cancer

EP.07.11 Comparison of Robotic Assisted Thoracoscopic Lobectomy and Video-Assisted Thoracoscopic Lobectomy for Early Stage Non-Small Cell Lung Cancer

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This retrospective cohort study compared robotic-assisted thoracoscopic surgery (RATS) and video-assisted thoracoscopic surgery (VATS) lobectomy in 330 patients with early-stage (stage 0 or IA) non-small cell lung cancer (NSCLC) from 2014 to 2024. VATS, established as a minimally invasive gold standard, uses 2D video guidance but has limited instrument articulation and depth perception. RATS offers enhanced 3D high-definition imaging and wrist-like instruments, potentially enabling more precise surgical maneuvers.<br /><br />Among the 186 VATS and 144 RATS patients, baseline characteristics like age, sex, smoking status, clinical stage, and histology were comparable. RATS lobectomy utilized the Da Vinci Xi system with a five-port approach, while VATS used a 4-port technique. The study evaluated perioperative parameters, lymph node (LN) dissection, complications, and postoperative recovery.<br /><br />Key findings showed similar operative times (around 250 minutes) and postoperative hospital stays (9–9.5 days) between groups. However, RATS resulted in significantly less blood loss (33 g vs. 52 g; p=0.01) and a higher total number of lymph nodes dissected (18.5 vs. 16; p=0.01). No significant differences existed in chest tube duration, conversion to thoracotomy, or postoperative complications. The number of upstaged N1 and N2 nodes was comparable. Propensity score matching confirmed these results.<br /><br />The study concludes that RATS offers similar perioperative safety and efficacy to VATS with the advantage of more extensive lymph node dissection. Enhanced visualization and instrument dexterity in RATS may facilitate improved surgical precision, potentially contributing to better long-term oncologic outcomes in early-stage NSCLC patients undergoing minimally invasive lobectomy.

Asset Subtitle

Tomoyoshi Takenaka

Meta Tag

Speaker Tomoyoshi Takenaka

Topic Early-Stage Non-small Cell Lung Cancer

Keywords

Robotic-assisted thoracoscopic surgery

Video-assisted thoracoscopic surgery

Non-small cell lung cancer

Lobectomy

Minimally invasive surgery

Lymph node dissection

Perioperative outcomes

Da Vinci Xi system

Surgical precision

Early-stage lung cancer