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

Autor:	Kent MS; Division of Thoracic Surgery, and Interventional Pulmonology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston MA., Hartwig MG; Division of Thoracic Surgery, Duke University, Durham, NC., Vallières E; Division of Thoracic Surgery, Swedish Cancer Institute, Seattle, WA., Abbas AE; Division of Thoracic Surgery, Temple University Health System, Philadelphia, PA., Cerfolio RJ; Division of Thoracic Surgery, NYU Langone, New York, NY., Dylewski MR; General Thoracic Surgery, Baptist Health Medical Group, South Miami, FL., Fabian T; Division of Thoracic Surgery, Albany Medical Center, Albany, NY., Herrera LJ; Rod Taylor Thoracic Care Center, Orlando Health UF Health Cancer Center, Orlando FL., Jett KG; Division of Thoracic Surgery, Baylor Scott & White The Heart Hospital - Plano, Plano, TX., Lazzaro RS; Department of Cardiothoracic Surgery, Northwell Health, New York, NY., Meyers B; Department of Surgery, Washington University School of Medicine in St. Louis, St. Louis, MO., Mitzman BA; Division of Thoracic Surgery, NYU Winthrop, Mineola, NY., Reddy RM; Division of Thoracic Surgery, University of Michigan Medical Center, Ann Arbor, MI., Reed MF; Division of Thoracic Surgery, Penn State Cancer Institute, Hershey, PA., Rice DC; Department of Thoracic and Cardiovascular Surgery, The University of Texas M.D. Anderson Cancer., Ross P; Main Line Health Care Thoracic Surgery, Main Line Health, Wynewood, PA., Sarkaria IS; Department of Cardiothoracic Surgery, Division of Thoracic Surgery, UPMC, Pittsburgh, PA., Schumacher LY; Division of; Thoracic Surgery, Massachusetts General Hospital, Boston, MA., Tisol WB; Care, Grafton, MI; and., Wigle DA; Division of General Thoracic Surgery, Mayo Clinic, Rochester, MN., Zervos M; Division of Thoracic Surgery, NYU Langone, New York, NY.
Jazyk:	angličtina
Zdroj:	Annals of surgery [Ann Surg] 2023 Mar 01; Vol. 277 (3), pp. 528-533. Date of Electronic Publication: 2021 Sep 16.
DOI:	10.1097/SLA.0000000000005115
Abstrakt:	Objective: 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. Competing Interests: The authors report no conflicts of interest. (Copyright © 2022 The Author(s). Published by Wolters Kluwer Health, Inc.)
Databáze:	MEDLINE
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