Robotic-Assisted Lung Surgery Improves Patient Outcomes

A new study claims that robotic-assisted lobectomy is associated with significantly lower death rates, lower overall complication rates, and shorter hospital stays when compared to open surgery.

Researchers at Beth Israel Deaconess Medical Center and Harvard Medical School (Boston, MA, USA) reviewed US state inpatient databases (SIDs) from 2008 to 2012, identifying 33,095 patients in eight states who underwent open surgery (20,238 patients), video-assisted thoracic surgery (VATS, 12,427 patients), or robotic-assisted surgery (430 patients) to remove diseased lung tissue. Patients who underwent segmentectomy were also included. A comparison of outcomes was performed using a propensity-matched analysis.

The results showed that compared to traditional open surgery, robotic-assisted surgery was associated with a significantly reduced mortality (0.2% versus 2%), shorter hospital stays (5.9 days versus. 8.2 days), and a lower overall complication rate (43.8% versus. 54.1%). The results also indicated that the death rate, length of hospital stays, and overall complication rate for robotic-assisted surgery were similar to or better than VATS, but none of the differences were statistically significant. The study was published in the October 2013 issue of the Annals of Thoracic Surgery.

“Case volume for robotic pulmonary resections has increased significantly during the study period, and thoracic surgeons have been able to adopt the robotic approach safely,” concluded lead author Michael Kent, MD, and colleagues of division of thoracic surgery and interventional pulmonology. “Robotic resection appears to be an appropriate alternative to VATS and is associated with improved outcomes compared with open thoracotomy.”

Lobectomy of the lung is performed in early stage non-small-cell lung cancer (NSCLC) patients; it is not performed on patients that have lung cancer that has metastasized to other parts of the body. Tumor size, type, and location are other major factors as to whether a lobectomy is to be performed.

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Beth Israel Deaconess Medical Center and Harvard Medical School