Presented at the Academic Surgical Congress 2016Upstaging and survival after robotic-assisted thoracoscopic lobectomy for non-small cell lung cancer
Section snippets
Material and methods
This retrospective analysis included prospectively collected data from all patients who underwent R-VATS pulmonary lobectomy, including those who first underwent R-VATS wedge resection followed by R-VATS completion lobectomy and those converted to open lobectomy, for NSCLC by one surgeon at our institution from September 2010 through January 2015. We excluded patients who underwent R-VATS lobectomy for other pathology, such as small-cell carcinoma, pulmonary metastasis, or benign lesions and
Results
A total of 287 patients underwent robotic-assisted pulmonary lobectomy between September 2010 and January 2015. Thirty-eight patients were excluded after the final pathology report, leaving 249 patients with NSCLC for evaluation. The mean age for the final cohort was 67.8 ± 0.6 years, with additional demographics reported in Table I.
The most common pulmonary lobe resected was the right upper lobe (Table II). Our median skin-to-skin operative time was 178 minutes, and our overall conversion rate
Discussion
Analysis of our cohort of patients who underwent R-VATS lobectomy revealed a median skin-to-skin operative time, overall and emergent conversion rates, and rates of major perioperative outcomes comparable to those that have been previously described for R-VATS as well as for conventional VATS and open lobectomy.10, 11, 12 A meta-analysis on robotic-assisted pulmonary lobectomy, including data from 326 patients, showed a pooled average operative time of 215 minutes and overall conversion rate of
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The Role of Lung Cancer Surgical Technique on Lymph Node Sampling and Pathologic Nodal Upstaging
2023, Annals of Thoracic SurgeryLong-Term Oncologic Outcomes After Robotic Lobectomy for Early-stage Non–Small-cell Lung Cancer Versus Video-assisted Thoracoscopic and Open Thoracotomy Approach
2020, Clinical Lung CancerCitation Excerpt :The lymph node harvest is measured by the number of lymph nodes removed, and the rate of upstaging has been exemplary in reported studies, which has been attributed to the ease of precise dissection in remote mediastinal locations using the robotic instruments. Studies have frequently reported lymph node counts that have far exceeded the quality benchmark of harvesting 10 lymph nodes, and the rate of lymph node usptaging has been at least comparable to that of VATS.6,21,22 However, long-term survival and disease control remain the most important objective measures of oncologic efficacy.
Propensity-score adjusted comparison of pathologic nodal upstaging by robotic, video-assisted thoracoscopic, and open lobectomy for non–small cell lung cancer
2019, Journal of Thoracic and Cardiovascular SurgeryCitation Excerpt :The adequacy of LN dissection with minimally invasive thoracoscopic resections has been controversial for as long as they have existed. Most recently, the use of robotic lung surgery is increasing rapidly, and several studies have reported good experiences with LN dissection, and nodal upstaging ranging from 10% to 16.4%.12-14,16,17 The relative ease of LN dissection is credited to the high-definition robotic camera and the wristed robotic instrumentation with increased freedom of motion and maneuverability in the chest.18
Long-term oncologic results for robotic major lung resection in non-small cell lung cancer (NSCLC) patients
2019, Surgical OncologyCitation Excerpt :Currently, significant studies with long term survival data for NSCLC advanced stage patients, are lacking. Recently, Toosi et al. analyzed the oncological outcomes of 247 NSCLC patients, not only in early stages (134 pI, 44 pII, 59 pIII, 10 pIV), who underwent robotic surgery and reported a 3-year OS of 75%, 73%, 44% and 0% for pI, pII, pIII and pIV respectively [17]. The latest NCCN guidelines, considering the effectiveness of procedure, suggest that minimally-invasive approach should be proposed to all patients whenever possible [18]; for this reason, thanks to the advanced robotic technology and the standardization of surgical procedure, is considerable to extend the indications of robotic surgery also to advanced stage NSCLC patients.
E.M.T. and J.P.F. have had financial relationships with Intuitive Surgical Corporation in form of honoraria as robotic thoracic surgery proctors and observation sites. No other authors have any actual or potential financial or non-financial conflicts of interest to disclose.