Short-Term Outcomes of Robot-Assisted vs Uniportal VATS for Right Upper Lobectomy in NSCLC

Overview

This study compared short-term outcomes of da Vinci robot-assisted surgery and uniportal video-assisted thoracoscopic surgery (U-VATS) for right upper lobectomy in early-stage non-small cell lung cancer (NSCLC). Both approaches showed similar safety and efficacy, with the robot-assisted group achieving a higher number of lymph node dissections and a higher R0 resection rate.

Background

Non-small cell lung cancer (NSCLC) is commonly treated surgically in early stages, with right upper lobectomy being a standard procedure. Minimally invasive techniques such as uniportal video-assisted thoracoscopic surgery (U-VATS) and robot-assisted surgery have been developed to reduce surgical trauma and improve outcomes. Comparing these approaches is important to optimize surgical management and patient recovery.

Data Highlights

Key Findings

• No significant differences in baseline patient characteristics between groups.
• R0 resection rate was higher in the da Vinci robot group (86.00%) compared to U-VATS (73.47%), though not statistically significant.
• da Vinci robot-assisted surgery resulted in a significantly higher number of lymph node dissections (P < 0.05).
• No significant differences in surgical time, intraoperative blood loss, chest tube drainage, drainage duration, or postoperative hospital stay.
• Incidence of postoperative complications was similar between both surgical approaches.
• Survival rates were comparable, with no statistically significant difference between groups.

Clinical Implications

Both da Vinci robot-assisted and uniportal VATS approaches are safe and effective for right upper lobectomy in early-stage NSCLC. The higher lymph node yield with robot-assisted surgery may provide improved oncological staging. Surgical teams can consider either technique based on available resources and expertise without compromising short-term patient outcomes.

Conclusion

Robot-assisted and uniportal VATS right upper lobectomy demonstrate comparable short-term safety and efficacy in early-stage NSCLC, with robot-assisted surgery offering enhanced lymph node dissection. These findings support the use of either minimally invasive approach tailored to clinical context.

References

1. Nanxishan Hospital of Guangxi Zhuang Autonomous Region, 2024 -- Evaluation of Short-Term Outcomes in Robot-Assisted versus Uniportal Video-Assisted Thoracoscopic Surgery for Right Upper Lobectomy in Patients with Non-Small Cell Lung Cancer