Comparison of robot-assisted and video-assisted thoracic sleeve lobectomy in non-small cell lung cancer: insights from a high-volume center

Abstract

Background: Although minimally invasive sleeve lobectomy (SL) preserves lung function, it is a complex and demanding thoracic surgical technique. This study aimed to evaluate perioperative and long-term outcomes of robot-assisted thoracic surgery (RATS) versus video-assisted thoracic surgery (VATS) in patients with non-small cell lung cancer (NSCLC) undergoing SL, and explore the safety and feasibility of robot-assisted SL in patients following neoadjuvant therapy. Methods: A retrospective analysis was performed on a cohort of patients diagnosed with NSCLC who underwent minimally invasive SL at a high-volume center between December 2019 and February 2023. Demographic characteristics, perioperative outcomes, and survival rates were compared between the RATS and VATS groups. Results: 18.2%; P=0.01) than the VATS group. The overall median follow-up for the entire cohort was 34 [interquartile range (IQR), 26-42] months, with 30 (IQR, 26-38) months in the RATS group and 35 (IQR, 25-44) months in the VATS group. The Kaplan-Meier survival curves showed no significant difference in overall survival and progression-free survival (P=0.68 and P=0.98, respectively) between the groups. Conclusions: Robot-assisted SL shows comparable results to VATS group for perioperative and long-term tumor prognosis. For patients who have received neoadjuvant therapy, robot-assisted SL is a safe and feasible option.