Robotic Lobectomy is Cost-Effective and Provides Comparable Health Utility Scores to Video-Assisted Lobectomy

Annals of Surgery, Journal Year: 2023, Volume and Issue: unknown

Published: Aug. 8, 2023

Objective: Determine if robotic-assisted lobectomy (RPL-4) is cost-effective and offers improved patient-reported health utility for patients with early-stage NSCLC when compared to video-assisted (VATS-Lobectomy). Summary Background Data: Barriers against the adoption of RPL-4 in publicly-funded healthcare include paucity high-quality prospective trials perceived high cost robotic surgery. Methods: Patients were enrolled a blinded, multi-centered, RCT Canada, USA, France, randomized 1:1 either or VATS-Lobectomy. EQ-5D-5L was administered at baseline post-operative day 1; weeks 3, 7, 12; months 6 12. Direct indirect costs tracked using standard methods. Seemingly Unrelated Regression applied estimate effect, adjusting utility. Incremental effectiveness ratio generated by 10,000 bootstrap samples multivariate imputation chained equations. Results: Of 406 screened, 186 randomized, 164 analyzed after final eligibility review (RPL-4:n=81; VATS-Lobectomy:n=83). Twelve-month follow-up completed 94.51%(155/164) participants. Median age 68(60-74). There no significant differences body mass index, comorbidity, pulmonary function, smoking status, utility, tumor characteristics between arms. The mean 12-week score 0.85(0.10) 0.80(0.19) VATS-Lobectomy ( P =0.02). Significantly more lymph nodes sampled [10(8-13) vs 8(5-10); =0.003] arm. incremental cost/QALY $14,925.62(95% CI $6,843.69,$23,007.56) 12-months. Conclusions: Early results RAVAL trial suggest that associated comparable short-term scores

Language: Английский

---

Quality of Life Outcomes Between Robotic-Assisted and Video-Assisted Thoracoscopic Surgery for Early Stage Non-Small Cell Lung Cancer

JTCVS Open, Journal Year: 2025, Volume and Issue: 24, P. 383 - 393

Published: Jan. 22, 2025

Limited research exists comparing the impacts of robotic-assisted thoracic surgery (RATS) and video-assisted (VATS) on patients' physical mental health-related quality life (QoL). A prospective cohort stage IA non-small cell lung cancer (NSCLC) patients in Initiative for Early Lung Cancer Research Treatment from Mount Sinai Health System had QoL measured before at 2, 6, 12 months post-treatment using Medical Outcomes Study Short-Form (SF-12), with Physical Component Summary (PCS) Mental (MCS); Functional Assessment Therapy-Lung Subscale (FACT-LCS); Patient Questionnaire-4 (PHQ-4; depression/anxiety). locally weighted smoothing curve was fitted to identify best interval knot trends. piecewise linear mixed-effects model developed estimate differences baseline, 2-month, 12-month scores rates change, adjusting age, sex, race, ethnicity, smoking status, pack-years, nodule size/consistency, comorbidities, surgical extent. The study comprised 698 patients, including 458 (65.6%) who underwent VATS 240 (34.4%) RATS. RATS group exhibited a more significant initial decline health 2 post-surgery but showed recovery by months, achieving similar or slightly higher compared baseline. No over time were seen between groups. Both groups displayed consistent anxiety depression scores, improvements symptoms 2-month mark. fewer postoperative complications conversion open thoracotomy. offer long-term outcomes early-stage NSCLC though may experience sharper health.

Language: Английский

---

Clinicopathological features and perioperative outcomes of robot-assisted thoracoscopic surgery for primary lung cancer: An analysis of initial outcomes based on the National Clinical Database

Surgery Today, Journal Year: 2025, Volume and Issue: unknown

Published: Feb. 7, 2025

Language: Английский

---

Comparative short-term outcomes of robotic-assisted vs video-assisted thoracic surgery in lung cancer: a multicenter retrospective study from EPITHOR with a quality audit

Journal of Robotic Surgery, Journal Year: 2025, Volume and Issue: 19(1)

Published: Feb. 12, 2025

Advancements in diagnostic imaging and surgical techniques have significantly evolved the treatment landscape of non-small cell lung cancer (NSCLC). The shift toward parenchymal-sparing approaches, such as segmentectomy for cT1a-bN0 tumors, is challenging traditional lobectomy. This retrospective multicenter cohort study evaluates short-term outcomes Video-Assisted Thoracoscopic Surgery (VATS) Robotic-Assisted Thoracic (RATS) NSCLC patients using data from French EPITHOR registry, enhanced by an in-depth quality audit. audit ensured completeness accuracy monitoring improving entry at participating centers. We included who underwent mini-invasive lobectomy or between January 2016 December 2020. primary outcome was length hospital stay (LOS), with secondary including complications, 90-day rehospitalization, mortality. A total 5687 interventions were analyzed, 3692 VATS 1995 RATS procedures. unadjusted mean LOS slightly shorter (7.61 days) compared to (8.04 days), though this difference not statistically significant after adjustment (p = 0.073). No differences found outcomes, complication rates integration a comprehensive allowed robust comparison ensuring reliable accurate across all While showed trend stays, did find adjusting confounders. Both are viable options resections, choice potentially guided surgeon expertise institutional resources.

Language: Английский

---

Comparing perioperative outcomes in video-assisted thoracic surgery and robot-assisted thoracic surgery in lung cancer surgeries: a single-centre experience

The Cardiothoracic Surgeon, Journal Year: 2025, Volume and Issue: 33(1)

Published: Feb. 18, 2025

Abstract Background Lung cancer continues to be the primary cause of cancer-related deaths worldwide, with surgical resection recognised as gold standard for non-small cell lung cancer. Recent innovations in thoracic surgery, including video-assisted surgery and robotic-assisted have revolutionised methodologies. This study seeks evaluate perioperative outcomes procedures, concentrating on postoperative complications, length hospital stay, overall efficacy based a single-centre experience. Results A total 269 resections were conducted, 176 (65.4%) completed using 93 (34.6%) utilising surgery. No notable disparities observed demographics or preoperative characteristics between groups. The complication rates 13.1% 16.1% ( p = 0.507). substantial changes specific problems, such air leaks infections. average duration was 3.26 days 3.70 0.252), 30-day mortality rate 0.6% 0% Conclusions Video-assisted produce similar results showing no statistically significant differences fatality rates. These findings correspond current literature, indicating that although may present benefits, both strategies is comparable. Future research larger cohorts crucial gain more in-depth understanding these techniques their long-term effects patient outcomes.

Language: Английский

---

Robotic Innovations in Thoracic Surgery: State of the Art and Future Perspectives

IntechOpen eBooks, Journal Year: 2025, Volume and Issue: unknown

Published: Feb. 13, 2025

This chapter examines the profound impact of robotic technology on thoracic surgery, emphasizing current innovations and future prospects. We begin with a brief historical overview systems, focusing their evolution from early models to Intuitive da Vinci platforms latest advancements in surgical robotics. The core our analysis is comparative effectiveness robotic-assisted surgery (RATS) against traditional video-assisted (VATS) open techniques. Key benefits RATS discussed include enhanced precision, minimized patient trauma, improved clinical outcomes, such as decreased hospitalization times lymph node harvesting. Further, delves into integration robotics training, highlighting role features dual-console setups. explore ongoing technological advancements, incorporation artificial intelligence imaging techniques, which are set expand capabilities efficiency RATS. assess potential emerging implications features, single-port access AI-driven tools, for procedures. Challenges cost, accessibility, steep learning curve associated these technologies also analysed provide balanced view landscape surgery.

Language: Английский

---

Management of iatrogenic bronchial tear during one‐lung ventilation for robotic thoracic surgery

Anaesthesia Reports, Journal Year: 2025, Volume and Issue: 13(1)

Published: Jan. 1, 2025

Summary Intra‐operative airway injuries in robotic thoracic surgery pose unique challenges for the anaesthetist and surgeon. Close communication between anaesthetic surgical team is vital providing adequate one‐lung ventilation a successful operation. We describe case of intra‐operative iatrogenic bronchial tear subsequent cuff rupture, requiring immediate specialist management. Management priorities include safe oxygenation, lung isolation to allow completion resection.

Language: Английский

---

Performance of Intraoperative Contrast-Enhanced Ultrasound (Io-CEUS) in the Diagnosis of Primary Lung Cancer

Diagnostics, Journal Year: 2024, Volume and Issue: 14(15), P. 1597 - 1597

Published: July 24, 2024

Suspicious tumors of the lung require specific staging, intraoperative detection, and histological confirmation. We performed an intrathoracic, contrast-enhanced ultrasound (Io-CEUS) for characterization cancer.

Language: Английский

---

A Comparison of Short-Term Outcomes of Robotic-Assisted Thoracic Surgery Versus Video-Assisted Thoracic Surgery Following Lung Cancer Surgery at a Tertiary Hospital in the United Kingdom: A Propensity-Matched Analysis

Cureus, Journal Year: 2024, Volume and Issue: unknown

Published: July 11, 2024

Background: Robot-assisted thoracic surgery (RATS) is gaining popularity in lung resection surgeries; however, its quality outcome measures require further evaluation. This study compared the short-term perioperative outcomes of surgeries performed using RATS and video-assisted (VATS) at a tertiary hospital UK. Methods: We retrospective comparative analysis 496 patients who underwent Castle Hill Hospital UK between January 2021 April 2024. In pre-matched cohort, 162 to 334 VATS. Using propensity matching based on patient's forced expiratory volume one second (FEV1) percentage predicted age body mass index (BMI), we included 324 analysis. Of these, RATS, VATS, demonstrating satisfactory performance indicators. Results: The results from our depicted that had significantly lower rate prolonged air leak (≥7 minutes) than VATS (5.5% versus 7.1%, mean difference -1.32, 95% CI: -0.89-3.08, p = 0.034). also shorter duration stay (3.8 ± 4.1 days 4.7 4.8, -0.901, -1.886-0.084; 0.073) more mediastinal lymph node dissections (39.5% 35.2%) However, proportion were upstaged after histopathological resected nodes was not different two groups. Furthermore, groups no significant differences regarding infection rate, intermittent positive pressure ventilation (IPPV) use, theatre return. Conclusion: Robotic technologies produced equivalent for majority evaluated. Additional research necessary confirm RATS's efficacy determine potential advantages over surgeries.

Language: Английский

---

Intraoperative Molecular Imaging with Pafolacianine: Histologic Characteristics Of Identified Nodules

Clinical Lung Cancer, Journal Year: 2024, Volume and Issue: unknown

Published: Nov. 1, 2024

Language: Английский

---