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ORIGINAL RESEARCH article
Front. Surg.
Sec. Thoracic Surgery
Volume 11 - 2024 |
doi: 10.3389/fsurg.2024.1417787
This article is part of the Research Topic Improving Long-Term Survival after Minimally Invasive Lung Cancer Surgery: Comparison between Robotic- and Video-Assisted Surgery View all articles
Robotic Thoracic Surgery: Lessons learned from the first 1000 procedures
Provisionally accepted- 1 Groupe Hospitalier Privé Ambroise Paré hartmann, Neuilly-sur-Seine, France
- 2 Centre Hospitalier Universitaire (CHU) de Rouen, Rouen, France
- 3 Service de Chirurgie Viscérale et Urologique Pédiatrique, Hôpital Necker-Enfants Malades, Paris, France
Introduction: The aim of this study was to evaluate the impact of thoracic robotic approach in high volume center regarding procedures and clinical outcomes after 1000 procedures.Methods: In a single-center subset of the EpithorÒ database, a prospective cohort database of French thoracic surgery, we analyzed procedural characteristics and clinical outcomes from February 2014 to April 2023. Surgical technique for lung surgery was conducted with a 4-arm closed chest with port access approach and vascular sewing and knotting was preferred over stapling. Statistical analysis was performed using Chi-2 test for discontinuous variables and the Mann-Whitney-Wilcoxon test for continuous variable. Test were considered significant for a p value below 0.05.Results: Robotic thoracic surgery concerned anatomical lung resection in 85% case.Over the study period, 1067 patients underwent robotic surgery, from which 509 had lobectomies and 391 segmentectomies. In the segmentectomy group vs lobectomy group we observed a shorter length of stay (9+/-7d vs 7+/-5.6d p<0.001), a shorter surgery time (99+/-24min vs 116+/-38min, p<0.001) a lower conversion rate (n=2 vs n=17, p=0.004) and a lower complication rate (28% vs 40%, p=0.009, mainly Clavien Dindo II, 18% and 28% respectively). For cancer treatment surgery, we found more previous cancer in the segmentectomy group (48% vs 26%, p<0.001). We also observed a progressive change of lobectomy vs segmentectomy from 80%/20% to 30%/70% over the nine years.Discussion: Robotic platform is an appropriate tool to perform anatomical lung resection and especially to develop lung sparing sub lobar resection in a safe and systematic approach.
Keywords: Robot-assisted thoracic surgery, Rats, Lobectomy, segmentectomy, Non-small cell lung cancer, Sublobar resection
Received: 15 Apr 2024; Accepted: 26 Aug 2024.
Copyright: © 2024 Durand, Nguyen, Mbadinga, Pryshchepau, Portefaix, Chaabane, Ropert and Khen-Dunlop. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Marion Durand, Groupe Hospitalier Privé Ambroise Paré hartmann, Neuilly-sur-Seine, France
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