Survival Outcomes for Robot- Versus Video-Assisted Thoracic Surgery

Robot-assisted thoracic surgery (RATS) resulted in less elevation of interleukin (IL)-6 levels in patients undergoing lung resections compared with video-assisted thoracoscopic surgery (VATS), which “may translate to better overall outcomes following surgery, including longer survival,” according to the authors of a study being presented at the CHEST Annual Meeting 2019.

The researchers prospectively evaluated the impact of RATS versus VATS on inflammatory cytokine levels in the immediate postoperative period. A total of 30 patients undergoing minimally invasive lung resection for malignancy were included and underwent VATS (n=14) or RATS (n=16). Researchers obtained blood samples in the operating room preoperatively and again at two and 24 hours post-surgery. All patients underwent intercostal blocks and incisional infiltration with liposomal bupivacaine during surgery.

This cohort underwent lobectomy (n=20), segmentectomy (n=3) , and wedge resection (n=7). Patients in the RATS cohort tended to be older (median age, 74.5 vs. 65.5 years).

The RATS group had less operative time compared with the VATS cohort (165 vs. 196 minutes), as well as less hospital length of stay (3 vs. 3.5 days). From preoperatively to two and 24 hours postoperatively, IL-8, IL-10, and MCP-1 were significantly higher in both groups when epidermal growth factor was lower (P<0.001).

Reference

  1. Curran B, Poulikidis K, Rodrigues A, et al. Robotic lung resection causes less inflammatory response compared to video-assisted thoracoscopic lung resection. Presented at the CHEST Annual Meeting 2019. October 19-23, 2019; New Orleans, Louisiana.