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Effect of da Vinci robot versus thoracoscopic surgery on lung function and oxidative stress levels in NSCLC patients: a propensity score-matched study

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Abstract

Background

To evaluate the short-term efficacy, lung function, and oxidative stress levels between the robotic-assisted thoracoscopic surgery (RATS) and video-assisted thoracoscopic surgery group (VATS) for non-small cell lung cancer (NSCLC).

Methods

We conducted a retrospective cohort study, selecting 248 NSCLC patients who underwent minimally invasive lobectomy at the Department of Thoracic Surgery, Gansu Provincial People’s Hospital, from August 2019 to February 2023. There were 105 patients in the RATS group and 143 patients in the VATS group. The patients in the two groups were subjected to 1:1 propensity score matching analysis (PSM), and the perioperative indicators were recorded. The levels of oxidative stress factors (superoxide dismutase, SOD; malondialdehyde, MDA) and inflammatory factors were measured 1 day before surgery and 3 days after surgery, respectively. Pulmonary function and patient quality of life were measured at 1 day preoperatively and 3 months postoperatively.

Results

There are 93 patients in each group after PSM. Compared to the VATS group, the RATS group had shorter operation time, less intraoperative blood loss, greater number and groups of lymph nodes cleared, and shorter postoperative hospital stay. The SOD level in the RATS group was higher and the MDA level was lower than that in the VATS group after surgery. Postoperative inflammatory cytokine levels were less elevated in the RATS group than in the VATS group. At 3 months postoperatively, FVC%, FEV1%, and GQOLI-74 scores were higher in the RATS group than in the VATS group.

Conclusion

Compared to VATS lobectomy, RATS lobectomy has the advantages of shorter operative time, lesser bleeding, more lymph node dissection, faster postoperative recovery, and lesser impact on postoperative lung function. It is also capable of reducing the postoperative oxidative stress and inflammatory response, which can improve patients’ quality of life.

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Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request. No additional data are available.

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Author notes

  1. Ziqiang Hong and Qing Liu have contributed equally to the work.

Authors and Affiliations

  1. The First Clinical Medical College of Gansu University of Chinese Medicine, Lanzhou, 730000, Gansu, China

    Ziqiang Hong, Hongchao Li, Baiqiang Cui, Tao Cheng, Yingjie Lu & Xusheng Wu

  2. Department of Thoracic Surgery, Gansu Provincial Hospital, Lanzhou, 730000, Gansu, China

    Ziqiang Hong, Hongchao Li, Baiqiang Cui, Tao Cheng, Xusheng Wu, Dacheng Jin, Yunjiu Gou & Xinchun Dong

  3. Department of Thoracic Surgery, Lanzhou University Second Hospital, Lanzhou, 730000, Gansu, China

    Qing Liu

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  1. Ziqiang Hong
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Contributions

Conception and design: ZQH, YJG, and XCD; Administrative support: YJG; Provision of study materials or patients: QL, HCL, BQC, and YJL; Collection and assembly of data: XSW and TC; Data analysis and interpretation: DCJ; Revise the manuscript: ZQH, QL, HCL, YJG, and XCD; Manuscript writing: All authors; Final approval of manuscript: All authors.

Corresponding authors

Correspondence to Yunjiu Gou or Xinchun Dong.

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Disclosures

The authors, Ziqiang Hong; Qing Liu; Hongchao Li; Baiqiang Cui; Tao Cheng; Yingjie Lu; Xusheng Wu; Dacheng Jin; Yunjiu Gou; and Xinchun Dong, have no conflicts of interest or financial ties to disclose.

Ethical approval

The study was reviewed by the Ethics Committee of Gansu Provincial Hospital, approval number: 2023-236.

Informed to consent

Informed consent was obtained from all individual participants included in the study necessary. Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.

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Hong, Z., Liu, Q., Li, H. et al. Effect of da Vinci robot versus thoracoscopic surgery on lung function and oxidative stress levels in NSCLC patients: a propensity score-matched study. Surg Endosc 38, 706–712 (2024). https://doi.org/10.1007/s00464-023-10577-x

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  • DOI: https://doi.org/10.1007/s00464-023-10577-x

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