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Comparison of Short-Term Outcomes Between Robot-Assisted and Video-Assisted Segmentectomy for Small Pulmonary Nodules: A Propensity Score-Matching Study

  • Thoracic Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Our study aimed to compare the short-term outcomes between robot-assisted segmentectomy (RAS) and video-assisted segmentectomy (VAS) for small pulmonary nodules.

Methods

The study included of 299 segmentectomies (132 RAS and 167 VAS procedures) for small pulmonary nodules between June 2018 and November 2021. The patients were divided into two groups: the RAS group and the VAS group. Propensity score-matching (PSM) analysis was performed to minimize bias. A logistic regression model was performed to identify the independent risk factors associated with complications.

Results

Before PSM, the following clinical variables were not balanced: age (P = 0.004), tumor size (P < 0.001), forced expiratory volume for 1 s (FEV1), and FEV1 percentage (P < 0.001). The patients with RAS had a shorter operative time (P = 0.014), less blood loss, a shorter postoperative hospital stay, less use of strong opioids, less drainage on postoperative day 1, and less postoperative total drainage, but more cost (all P < 0.001). Conversion to open surgery was performed for two patients in the VAS group but none in the RAS group. After PSM, 53 pairs were successfully matched. The data again suggested that the patients with RAS had less blood loss, a shorter postoperative hospital stay, and less use of strong opioids, but more cost (all P < 0.001). The operation time also was shorter in the RAS group, with a borderline statistically significant P value (0.053).

Conclusions

In our study, RAS had better short-term outcomes than VAS, indicating a safer and more efficient technique than VAS.

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Acknowledgment

This work was supported by the Sun Yat-sen University Clinical Research 5010 Program (2019012, ChiCTR2000034737), the Excellent Surgery Study Project of Bethune Charitable Foundation (CESS2021LB15), the Natural Science Foundation of Guangdong Province (2018A030313410, 2020A151501311), the National Natural Science Foundation of China (82072572), and the Guangzhou Science and Technology Program (202103000023).

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Author notes

  1. Mu-Zi Yang and Zi-Hui Tan have contributed equally to this report paper and share the first authorship.

Authors and Affiliations

  1. Department of Thoracic Surgery, Sun Yat-sen University Cancer Center, Guangzhou, China

    Mu-Zi Yang MD, Zi-Hui Tan MD, Chu-Long Xie MD, Tian-Yu Sun MD, Hao Long MD, Jian-Hua Fu MD, Lan-Jun Zhang MD, Peng Lin MD & Hao-Xian Yang MD

  2. State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China

    Mu-Zi Yang MD, Zi-Hui Tan MD, Ji-Bin Li PhD, Chu-Long Xie MD, Tian-Yu Sun MD, Hao Long MD, Jian-Hua Fu MD, Lan-Jun Zhang MD, Peng Lin MD & Hao-Xian Yang MD

  3. Department of Clinical Research, Sun Yat-sen University Cancer Center, Guangzhou, China

    Ji-Bin Li PhD

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Yang, MZ., Tan, ZH., Li, JB. et al. Comparison of Short-Term Outcomes Between Robot-Assisted and Video-Assisted Segmentectomy for Small Pulmonary Nodules: A Propensity Score-Matching Study. Ann Surg Oncol 30, 2757–2764 (2023). https://doi.org/10.1245/s10434-023-13179-y

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