Number of lymph nodes dissected and upstaging rate of the N factor in robot-assisted thoracic surgery versus video-assisted thoracic surgery for patients with cN0 primary lung cancer

• Published in: Surgery today (Tokyo, Japan) Vol. 53; no. 4; pp. 428 - 434
• Main Authors: Shindo, Yuma, Miyajima, Masahiro, Nakamura, Yasuyuki, Chiba, Yoshiki, Arai, Wataru, Aoyagi, Miho, Maki, Ryunosuke, Tsuruta, Kodai, Takahashi, Yuki, Tada, Makoto, Takase, Yoshiaki, Watanabe, Atsushi
• Format: Journal Article
• Language: English
• Published: Singapore Springer Nature Singapore 01.04.2023
• Subjects: Carcinoma, Non-Small-Cell Lung - surgery; Humans; Lung Neoplasms - pathology; Lung Neoplasms - surgery; Lymph Node Excision; Lymph Nodes - pathology; Lymph Nodes - surgery; Medicine; Medicine & Public Health; Original Article; Pneumonectomy; Retrospective Studies; Robotic Surgical Procedures; Robotics; Surgery; Surgical Oncology; Thoracic Surgery; Thoracic Surgery, Video-Assisted; RATS; VATS; Lymph node dissection; Upstaging rate of the N factor
• ISSN: 0941-1291; 1436-2813
• DOI: 10.1007/s00595-022-02578-5

Purpose The accuracy of lymph node (LN) dissection in robotic surgery for lung cancer remains controversial. We compared the accuracy of LN dissection in robot-assisted thoracic surgery (RATS) vs. video-assisted thoracic surgery (VATS). Methods The subjects of this retrospective analysis were 226 patients with cN0 primary lung cancer who underwent robot-assisted or video-assisted thoracic lobectomy with LN dissection, in our department, between April, 2016 and February, 2021. We compared the numbers of all LNs and mediastinal LNs dissected, the time required for LN dissection, complications, and upstaging rates of the N factor between the groups. Furthermore, we performed an inverse probability of treatment weighting-adjusted analysis to reduce potential bias between the groups. Results The number of dissected LNs was higher in the RATS group in both the unweighted and weighted analyses. The time required for lymph node dissection was also longer in RATS. There was no significant difference in complications or in the upstaging rate of the N factor between the groups. Conclusion More LNs were dissected with RATS. Thus, the usefulness of robot-assisted surgery for LN dissection needs to be investigated further.