Original articleGeneral thoracicComparison of Video-Assisted Thoracoscopic Surgery and Robotic Approaches for Clinical Stage I and Stage II Non-Small Cell Lung Cancer Using The Society of Thoracic Surgeons Database
Section snippets
Patients
The STS-GTD (data versions 2.081 to 2.2 covering 2009–2013) was queried for primary lobectomy operations for lung cancer. Operations without a VATS or robotic designation (33,645) or operations that were coded with both VATS/open (n = 303) or robotic/open (n = 416) were assumed to be “conversions” and were excluded. VATS and robotic cases were excluded if the reporting center had not done at least 20 robotic or 20 VATS cases (75 centers with 1,656 cases). Patients with clinical stage I or stage
Results
From a total of 52,505 cases, 1,220 robotic lobectomies and 12,378 VATS lobectomies from 140 reporting centers were identified. The number of robotic lobectomies increased each year, and the number of centers reporting experience with robotic lobectomy also increased. In the final year, robotic lobectomy accounted for 14% of all minimally invasive lobectomies (Fig 1). Of the 128 centers contributing cases, 18 reported both VATS and robotic approaches and 4 reported only robotic cases. Four of
Comment
The primary finding in this analysis is that there are no significant differences in perioperative outcomes between robotic lobectomy and VATS lobectomy. We also found no difference in nodal upstaging between the 2 procedures. Overall, these results are similar to the single-institution comparative studies of robotic lobectomy versus VATS 14, 16, the multiinstitutional comparative studies against the STS-GTD 18, 22, other administrative database comparisons [17], and a recent meta-analysis [23].
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