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Feasibility of four-arm robotic lobectomy as solo surgery in patients with clinical stage I lung cancer

Authors
 Seong Yong Park  ;  Jee Won Suh  ;  Kyoung Sik Narm  ;  Chang Young Lee  ;  Jin Gu Lee  ;  Hyo Chae Paik  ;  Kyoung Young Chung  ;  Dae Joon Kim 
Citation
 Journal of Thoracic Disease, Vol.9(6) : 1607-1614, 2017 
Journal Title
 Journal of Thoracic Disease 
ISSN
 2072-1439 
Issue Date
2017
Keywords
Lung cancer ; outcome ; robot
Abstract
BACKGROUND: This study was performed to investigate the feasibility of four-arm robotic lobectomy (FARL) as a solo surgical technique in patients with non-small cell lung cancer (NSCLC). Early outcome and long-term survival of FARL were compared with those of video-assisted thoracoscopic lobectomy (VATL). METHODS: Prospective enrollment of patients with clinical stage I NSCLC undergoing FARL or VATL (20 patients in each group) was planned. Interim analysis for early postoperative outcome was performed after the initial 10 cases in each group. RESULTS: The study was terminated early because of safety issues in the FARL group after enrollment of 12 FARL and 17 VATL patients from 2011 to 2012. There were no differences in clinical characteristics between groups. Lobectomy time and total operation time were significantly longer in the FARL group (P=0.003). There were three life-threatening events in the FARL group (2 bleedings, 1 bronchus tear) that necessitated thoracotomy conversion in 1 patient. There were no differences in other operative outcomes including pain score, complications, or length of hospital stay. Pathologic stage and number of dissected lymph nodes (LNs) were also comparable. During a follow-up of 48.9±9.5 months, recurrence was identified in 2 (16.7%) patients in FARL group and 3 (23.5%) in VATL group. Five-year overall survival (100% vs. 87.5%, P=0.386) and disease-free survival (82.5% vs. 75.6%, P=0.589) were comparable. CONCLUSIONS: FARL as solo surgery could not be recommended because of safety issues. It required a longer operation time and had no benefits over VATL in terms of early postoperative outcome or long-term survival.
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DOI
10.21037/jtd.2017.05.08
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Thoracic and Cardiovascular Surgery (흉부외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Dae Joon(김대준)
Narm, Kyoung Shik(남경식)
Park, Seong Yong(박성용)
Paik, Hyo Chae(백효채) ORCID logo https://orcid.org/0000-0001-9309-8235
Suh, Jee Won(서지원) ORCID logo https://orcid.org/0000-0003-0287-0651
Lee, Jin Gu(이진구)
Lee, Chang Young(이창영)
Chung, Kyung Young(정경영)
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/160408
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