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Pulmonary Open, Robotic, and Thoracoscopic Lobectomy (PORTaL) Study: An Analysis of 5721 Cases

The aim of this study was to analyze outcomes of open lobectomy (OL), VATS, and robotic-assisted lobectomy (RL). SUMMARY BACKGROUND DATA: Robotic-assisted lobectomy has seen increasing adoption for treatment of early-stage lung cancer. Comparative data regarding these approaches is largely from sing...

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Autores principales: Kent, Michael S., Hartwig, Matthew G., Vallières, Eric, Abbas, Abbas E., Cerfolio, Robert J., Dylewski, Mark R., Fabian, Thomas, Herrera, Luis J., Jett, Kimble G., Lazzaro, Richard S., Meyers, Bryan, Mitzman, Brian A., Reddy, Rishindra M., Reed, Michael F., Rice, David C., Ross, Patrick, Sarkaria, Inderpal S., Schumacher, Lana Y., Tisol, William B., Wigle, Dennis A., Zervos, Michael
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9891268/
https://www.ncbi.nlm.nih.gov/pubmed/34534988
http://dx.doi.org/10.1097/SLA.0000000000005115
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author Kent, Michael S.
Hartwig, Matthew G.
Vallières, Eric
Abbas, Abbas E.
Cerfolio, Robert J.
Dylewski, Mark R.
Fabian, Thomas
Herrera, Luis J.
Jett, Kimble G.
Lazzaro, Richard S.
Meyers, Bryan
Mitzman, Brian A.
Reddy, Rishindra M.
Reed, Michael F.
Rice, David C.
Ross, Patrick
Sarkaria, Inderpal S.
Schumacher, Lana Y.
Tisol, William B.
Wigle, Dennis A.
Zervos, Michael
author_facet Kent, Michael S.
Hartwig, Matthew G.
Vallières, Eric
Abbas, Abbas E.
Cerfolio, Robert J.
Dylewski, Mark R.
Fabian, Thomas
Herrera, Luis J.
Jett, Kimble G.
Lazzaro, Richard S.
Meyers, Bryan
Mitzman, Brian A.
Reddy, Rishindra M.
Reed, Michael F.
Rice, David C.
Ross, Patrick
Sarkaria, Inderpal S.
Schumacher, Lana Y.
Tisol, William B.
Wigle, Dennis A.
Zervos, Michael
author_sort Kent, Michael S.
collection PubMed
description The aim of this study was to analyze outcomes of open lobectomy (OL), VATS, and robotic-assisted lobectomy (RL). SUMMARY BACKGROUND DATA: Robotic-assisted lobectomy has seen increasing adoption for treatment of early-stage lung cancer. Comparative data regarding these approaches is largely from single-institution case series or administrative datasets. METHODS: Retrospective data was collected from 21 institutions from 2013 to 2019. All consecutive cases performed for clinical stage IA-IIIA lung cancer were included. Neoadjuvant cases were excluded. Propensity-score matching (1:1) was based on age, sex, race, smoking-status, FEV1%, Zubrod score, American Society of Anesthesiologists score, tumor size, and clinical T and N stage. RESULTS: A total of 2391 RL, 2174 VATS, and 1156 OL cases were included. After propensity-score matching there were 885 pairs of RL vs OL, 1,711 pairs of RL vs VATS, and 952 pairs of VATS vs OL. Operative time for RL was shorter than VATS (P < 0.0001) and OL (P = 0.0004). Compared to OL, RL and VATS had less overall postoperative complications, shorter hospital stay (LOS), and lower transfusion rates (all P<0.02). Compared to VATS, RL had lower conversion rate (P<0.0001), shorter hospital stay (P<0.0001) and a lower postoperative transfusion rate (P =0.01). RL and VATS cohorts had comparable postoperative complication rates. In-hospital mortality was comparable between all groups. CONCLUSIONS: RL and VATS approaches were associated with favorable perioperative outcomes compared to OL. Robotic-assisted lobectomy was also associated with a reduced length of stay and decreased conversion rate when compared to VATS.
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spelling pubmed-98912682023-02-07 Pulmonary Open, Robotic, and Thoracoscopic Lobectomy (PORTaL) Study: An Analysis of 5721 Cases Kent, Michael S. Hartwig, Matthew G. Vallières, Eric Abbas, Abbas E. Cerfolio, Robert J. Dylewski, Mark R. Fabian, Thomas Herrera, Luis J. Jett, Kimble G. Lazzaro, Richard S. Meyers, Bryan Mitzman, Brian A. Reddy, Rishindra M. Reed, Michael F. Rice, David C. Ross, Patrick Sarkaria, Inderpal S. Schumacher, Lana Y. Tisol, William B. Wigle, Dennis A. Zervos, Michael Ann Surg Original Articles The aim of this study was to analyze outcomes of open lobectomy (OL), VATS, and robotic-assisted lobectomy (RL). SUMMARY BACKGROUND DATA: Robotic-assisted lobectomy has seen increasing adoption for treatment of early-stage lung cancer. Comparative data regarding these approaches is largely from single-institution case series or administrative datasets. METHODS: Retrospective data was collected from 21 institutions from 2013 to 2019. All consecutive cases performed for clinical stage IA-IIIA lung cancer were included. Neoadjuvant cases were excluded. Propensity-score matching (1:1) was based on age, sex, race, smoking-status, FEV1%, Zubrod score, American Society of Anesthesiologists score, tumor size, and clinical T and N stage. RESULTS: A total of 2391 RL, 2174 VATS, and 1156 OL cases were included. After propensity-score matching there were 885 pairs of RL vs OL, 1,711 pairs of RL vs VATS, and 952 pairs of VATS vs OL. Operative time for RL was shorter than VATS (P < 0.0001) and OL (P = 0.0004). Compared to OL, RL and VATS had less overall postoperative complications, shorter hospital stay (LOS), and lower transfusion rates (all P<0.02). Compared to VATS, RL had lower conversion rate (P<0.0001), shorter hospital stay (P<0.0001) and a lower postoperative transfusion rate (P =0.01). RL and VATS cohorts had comparable postoperative complication rates. In-hospital mortality was comparable between all groups. CONCLUSIONS: RL and VATS approaches were associated with favorable perioperative outcomes compared to OL. Robotic-assisted lobectomy was also associated with a reduced length of stay and decreased conversion rate when compared to VATS. Lippincott Williams & Wilkins 2023-03 2021-09-16 /pmc/articles/PMC9891268/ /pubmed/34534988 http://dx.doi.org/10.1097/SLA.0000000000005115 Text en Copyright © 2022 The Author(s). Published by Wolters Kluwer Health, Inc. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.
spellingShingle Original Articles
Kent, Michael S.
Hartwig, Matthew G.
Vallières, Eric
Abbas, Abbas E.
Cerfolio, Robert J.
Dylewski, Mark R.
Fabian, Thomas
Herrera, Luis J.
Jett, Kimble G.
Lazzaro, Richard S.
Meyers, Bryan
Mitzman, Brian A.
Reddy, Rishindra M.
Reed, Michael F.
Rice, David C.
Ross, Patrick
Sarkaria, Inderpal S.
Schumacher, Lana Y.
Tisol, William B.
Wigle, Dennis A.
Zervos, Michael
Pulmonary Open, Robotic, and Thoracoscopic Lobectomy (PORTaL) Study: An Analysis of 5721 Cases
title Pulmonary Open, Robotic, and Thoracoscopic Lobectomy (PORTaL) Study: An Analysis of 5721 Cases
title_full Pulmonary Open, Robotic, and Thoracoscopic Lobectomy (PORTaL) Study: An Analysis of 5721 Cases
title_fullStr Pulmonary Open, Robotic, and Thoracoscopic Lobectomy (PORTaL) Study: An Analysis of 5721 Cases
title_full_unstemmed Pulmonary Open, Robotic, and Thoracoscopic Lobectomy (PORTaL) Study: An Analysis of 5721 Cases
title_short Pulmonary Open, Robotic, and Thoracoscopic Lobectomy (PORTaL) Study: An Analysis of 5721 Cases
title_sort pulmonary open, robotic, and thoracoscopic lobectomy (portal) study: an analysis of 5721 cases
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9891268/
https://www.ncbi.nlm.nih.gov/pubmed/34534988
http://dx.doi.org/10.1097/SLA.0000000000005115
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