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Comparison of uniportal robotic-assisted thoracic surgery pulmonary anatomic resections with multiport robotic-assisted thoracic surgery: a multicenter study of the European experience
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...
Autores principales: | , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
AME Publishing Company
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10080339/ https://www.ncbi.nlm.nih.gov/pubmed/37035654 http://dx.doi.org/10.21037/acs-2022-urats-27 |
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author | Manolache, Veronica Motas, Natalia Bosinceanu, Mugurel Liviu de la Torre, Mercedes Gallego-Poveda, Javier Dunning, Joel Ismail, Mahmoud Turna, Akif Paradela, Marina Decker, Georges Ramos, Ricard Bodner, Johanes Espinosa Jimenez, Dionisio Zardo, Patrick Garcia-Perez, Alejandro Ureña Lluveras, Anna Pantile, Daniel Gonzalez-Rivas, Diego |
author_facet | Manolache, Veronica Motas, Natalia Bosinceanu, Mugurel Liviu de la Torre, Mercedes Gallego-Poveda, Javier Dunning, Joel Ismail, Mahmoud Turna, Akif Paradela, Marina Decker, Georges Ramos, Ricard Bodner, Johanes Espinosa Jimenez, Dionisio Zardo, Patrick Garcia-Perez, Alejandro Ureña Lluveras, Anna Pantile, Daniel Gonzalez-Rivas, Diego |
author_sort | Manolache, Veronica |
collection | PubMed |
description | 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<0.0001]. Rate of complications and 30-day mortality was low in both groups. CONCLUSIONS: U-RATS is feasible and safe for anatomic lung resections and comparable to the multiport conventional approach regarding surgical outcomes. Given the similarity of the technique to uniportal VATS, it presents the potential to convert minimally invasive thoracic surgeons to a robotic-assisted approach. |
format | Online Article Text |
id | pubmed-10080339 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | AME Publishing Company |
record_format | MEDLINE/PubMed |
spelling | pubmed-100803392023-04-08 Comparison of uniportal robotic-assisted thoracic surgery pulmonary anatomic resections with multiport robotic-assisted thoracic surgery: a multicenter study of the European experience Manolache, Veronica Motas, Natalia Bosinceanu, Mugurel Liviu de la Torre, Mercedes Gallego-Poveda, Javier Dunning, Joel Ismail, Mahmoud Turna, Akif Paradela, Marina Decker, Georges Ramos, Ricard Bodner, Johanes Espinosa Jimenez, Dionisio Zardo, Patrick Garcia-Perez, Alejandro Ureña Lluveras, Anna Pantile, Daniel Gonzalez-Rivas, Diego Ann Cardiothorac Surg Featured Articles 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<0.0001]. Rate of complications and 30-day mortality was low in both groups. CONCLUSIONS: U-RATS is feasible and safe for anatomic lung resections and comparable to the multiport conventional approach regarding surgical outcomes. Given the similarity of the technique to uniportal VATS, it presents the potential to convert minimally invasive thoracic surgeons to a robotic-assisted approach. AME Publishing Company 2023-03-09 2023-03-31 /pmc/articles/PMC10080339/ /pubmed/37035654 http://dx.doi.org/10.21037/acs-2022-urats-27 Text en 2023 Annals of Cardiothoracic Surgery. All rights reserved. https://creativecommons.org/licenses/by-nc-nd/4.0/Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) . |
spellingShingle | Featured Articles Manolache, Veronica Motas, Natalia Bosinceanu, Mugurel Liviu de la Torre, Mercedes Gallego-Poveda, Javier Dunning, Joel Ismail, Mahmoud Turna, Akif Paradela, Marina Decker, Georges Ramos, Ricard Bodner, Johanes Espinosa Jimenez, Dionisio Zardo, Patrick Garcia-Perez, Alejandro Ureña Lluveras, Anna Pantile, Daniel Gonzalez-Rivas, Diego Comparison of uniportal robotic-assisted thoracic surgery pulmonary anatomic resections with multiport robotic-assisted thoracic surgery: a multicenter study of the European experience |
title | Comparison of uniportal robotic-assisted thoracic surgery pulmonary anatomic resections with multiport robotic-assisted thoracic surgery: a multicenter study of the European experience |
title_full | Comparison of uniportal robotic-assisted thoracic surgery pulmonary anatomic resections with multiport robotic-assisted thoracic surgery: a multicenter study of the European experience |
title_fullStr | Comparison of uniportal robotic-assisted thoracic surgery pulmonary anatomic resections with multiport robotic-assisted thoracic surgery: a multicenter study of the European experience |
title_full_unstemmed | Comparison of uniportal robotic-assisted thoracic surgery pulmonary anatomic resections with multiport robotic-assisted thoracic surgery: a multicenter study of the European experience |
title_short | Comparison of uniportal robotic-assisted thoracic surgery pulmonary anatomic resections with multiport robotic-assisted thoracic surgery: a multicenter study of the European experience |
title_sort | comparison of uniportal robotic-assisted thoracic surgery pulmonary anatomic resections with multiport robotic-assisted thoracic surgery: a multicenter study of the european experience |
topic | Featured Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10080339/ https://www.ncbi.nlm.nih.gov/pubmed/37035654 http://dx.doi.org/10.21037/acs-2022-urats-27 |
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