@misc{10498/29796,
year = {2023},
month = {3},
url = {http://hdl.handle.net/10498/29796},
abstract = {Background: Robotic-assisted thoracic surgery (RATS) has seen increasing interest in the last few years, with most procedures primarily being performed in the conventional multiport manner. Our team has developed a new approach that has the potential to convert surgeons from uniportal video-assisted thoracic surgery (VATS) or open surgery to robotic-assisted surgery, uniportal-RATS (U-RATS). We aimed to evaluate the outcomes of one single incision, uniportal robotic-assisted thoracic surgery (U-RATS) against standard multiport RATS (M-RATS) with regards to safety, feasibility, surgical technique, immediate oncological result, postoperative recovery, and 30-day follow-up morbidity and mortality. Methods: We performed a large retrospective multi-institutional review of our prospectively curated database, including 101 consecutive U-RATS procedures performed from September 2021 to October 2022, in the European centers that our main surgeon operates in. We compared these cases to 101 consecutive M-RATS cases done by our colleagues in Barcelona between 2019 to 2022. Results: Both patient groups were similar with respect to demographics, smoking status and tumor size, but were significantly younger in the U-RATS group [M-RATS =69 (range, 39–81) years; U-RATS =63 years (range, 19–82) years; P<0.0001]. Most patients in both operative groups underwent resection of a primary non-small cell lung cancer (NSCLC) [M-RATS 96/101 (95%); U-RATS =60/101 (59%); P<0.0001]. The main type of anatomic resection was lobectomy for the multiport group, and segmentectomy for the U-RATS group. In the M-RATS group, only one anatomical segmentectomy was performed, while the U-RATS group had twenty-four (24%) segmentectomies (P=0.0006). All M-RATS and U-RATS surgical specimens had negative resection margins (R0) and contained an equivalent median number of lymph nodes available for pathologic analysis [M-RATS =11 (range, 5–54); U-RATS =15 (range, 0–41); P=0.87]. Conversion rate to thoracotomy was zero in the U-RATS group and low in M-RATS [M-RATS =2/101 (2%); U-RATS =0/101; P=0.19]. Median operative time was also statistically different [M-RATS =150 (range, 60–300) minutes; U-RATS =136 (range, 30–308) minutes; P=0.0001]. Median length of stay was significantly lower in U-RATS group at four days [M-RATS =5 (range, 2–31) days; U-RATS =4 (range, 1–18) days; P[removed]},
publisher = {AME Publishing Company},
keywords = {lung cancer},
keywords = {multiport robotic-assisted thoracic surgery (M-RATS)},
keywords = {robotic lung resections},
keywords = {Uniportal robotic-assisted thoracic surgery (U-RATS)},
title = {Comparison of uniportal robotic-assisted thoracic surgery pulmonary anatomic resections with multiport robotic-assisted thoracic surgery: a multicenter study of the European experience},
doi = {10.21037/acs-2022-urats-27},
author = {Manolache, Veronica and Motas, Natalia and Bosinceanu, Mugurel Liviu and de la Torre, Mercedes and Gallego Poveda, Javier and Dunning, Joel and Ismail, Mahmoud and Turna, Akif and Paradela, Marina and Decker, Georges and Ramos, Ricard and Bodner, Johanes and Espinosa Jiménez, Dionisio and Zardo, Patrick and Garcia Perez, Alejandro and Ureña Lluveras, Anna and Pantile, Daniel and Gonzalez-Rivas, Diego},
}