In a nutshell
This study compared the short-term and long-term effectiveness between video-assisted thoracic surgery (VATS) and robot-assisted thoracic surgery (RATS) for the treatment of patients with non-small cell lung cancer (NSCLC). The data showed that RATS is a good and safe technique compared with VATS in terms of short-term and long-term outcomes.
Some background
NSCLC is the most common form of lung cancer. NSCLC is responsible for around 85% of all lung cancer diagnoses. Early-stage NSCLC is commonly treated with surgery. Thoracotomy involves a surgical incision into the chest wall. This is a common surgical procedure even though it is invasive.
A less invasive surgical method to treat early-stage NSCLC is called video-assisted thoracic surgery (VATS). VATS involves using a small camera that is inserted into the patients’ chest via a scope. Patients treated with VATS have less post-surgery pain, fewer complications, shorter hospital stay, and better survival than with thoracotomy.
Another less invasive procedure is called robot-assisted thoracic surgery (RATS). In RATS, the surgeon controls robotic devices to perform the procedure. However, there are few studies comparing the short-term and long-term effectiveness between VATS and RATS for the treatment of patients with NSCLC.
Methods & findings
This study analyzed 18 studies that involved 11,247 patients with NSCLC. 5114 patients were treated with RATS and 6133 patients were treated with VATS.
The average estimated blood loss was significantly lower in the RATS group compared with the VATS group. The average length of hospital stay was also significantly shorter for patients in the RATS group compared with the VATS group. Patients in the RATS group had more lymph nodes removed compared with the VATS group. 50% fewer patients treated with RATS needed thoracotomy compared to VATS. The time needed to drain the chest tubes after surgery was shorter for patients in the RATS group compared with the VATS group.
Patients in the RATS group had 10% lower overall complications after surgery and 49% lower recurrence rates compared with the VATS group. The total cost of treatment was significantly higher for the RATS groups than the VATS group.
There was no difference between RATS and VATS in terms of surgery time, mortality, overall survival (OS), and disease-free survival (DFS).
The bottom line
This study concluded that RATS is a good and safe technique compared with VATS in terms of short-term and long-term outcomes.
The fine print
Most of the studies analyzed looked back in time at medical records. More randomized controlled trials directly comparing the two techniques are still essential to fully evaluate the value of RATS for NSCLC.
Published By :
BMC cancer
Date :
May 03, 2021
