Robot-assisted thoracic surgery for benign tumors at the cervicothoracic junction: a propensity-matched study

• Published in: Scientific reports Vol. 14; no. 1; p. 4254
• Main Authors: Maitiyasen, Maierhaba, Peng, Hao, Liu, Yvxuan, Li, Jingfeng, Gao, Chuan, Chen, Jing, Yi, Jun
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 21.02.2024; Nature Publishing Group; Nature Portfolio
• Subjects: 692/4028/546; 692/700/784; Benign; Blood; Comorbidity; Humanities and Social Sciences; multidisciplinary; Patients; Quality of life; Respiratory function; Robotic surgery; Robots; Science; Science (multidisciplinary); Statistical analysis; Thoracic surgery; Thorax; Tumors
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-024-54653-1

This study aimed to assess the feasibility and safety of robot-assisted thoracic surgery (RATS) for resecting benign tumors of the cervicothoracic junction. Between 2017 and 2021, a total of 54 patients with benign cervicothoracic junction tumors were included. Among them, 46 underwent RATS while 8 underwent open surgery. Using a propensity score based on four variables (age, sex, comorbidity, and tumor size). The outcomes compared included short-term outcomes such as blood loss, as well as long-term outcomes including respiratory function and patients' postoperative health-related quality of life. No operative deaths occurred in this study. RATS was associated with less intraoperative blood loss (102 < 380 ml, P = 0.001) and a shorter length of hospital stay (1.8 < 4.8, P < 0.001). After a median follow-up of 37 months, no recurrences were reported, and no statistically significant differences were found in the 3-year survival between the two groups. The postoperative respiratory function of patients with open surgery showed a significant decrease compared to preoperative levels and were lower than those of RATS patients. In terms of health-related quality of life, RATS was associated with a better mean EQ-5D-5L index than open surgery (0.808 > 0.650, P < 0.05). In RATS, tumor sizes > 5 cm (mean ± SD = 0.768 ± 0.111, P = 0.028) and neurogenic tumors (mean ± SD = 0.702 ± 0.082, P < 0.001) remained significantly and independently associated with a lower EQ-5D-5L index. This study demonstrated that robot-assisted thoracic surgery for benign tumors of the cervicothoracic junction is a safe and technically feasible procedure, particularly for tumors < 5 cm and non-neurogenic tumors.