AI Article Synopsis
- Minimally invasive lung surgeries are more complex in obese patients, leading researchers to compare robotic surgery (RTS) with video-assisted thoracoscopic surgery (VATS).
- A study analyzed data from 8,108 obese patients with non-small cell lung cancer who underwent these procedures from 2015 to 2019, revealing that VATS had over a 5 times higher likelihood of requiring conversion to thoracotomy compared to RTS.
- Additionally, VATS patients experienced longer hospital stays, higher rates of respiratory failure, and were less likely to be discharged home compared to those undergoing RTS.
Article Abstract
Background: Minimally invasive lung resections can be particularly challenging in obese patients. We hypothesized robotic surgery (RTS) is associated with less conversion to thoracotomy than video-assisted thoracoscopic surgery (VATS) in obese populations.
Methods: The Society of Thoracic Surgeons General Thoracic Surgery Database, Epithor French National Database, and McMaster University Thoracic Surgical Database were queried for obese (body mass index ≥30 kg/m) patients who underwent VATS or RTS lobectomy or segmentectomy for clinical T1-2, N0-1 non-small cell lung cancer between 2015 and 2019. Propensity score adjusted logistic regression analysis was used to compare the rate of conversion to thoracotomy between the VATS and RTS cohorts.
Results: Overall, 8108 patients (The Society of Thoracic Surgeons General Thoracic Surgery Database: n = 7473; Epithor: n = 572; McMaster: n = 63) met inclusion criteria with a mean (SD) age of 66.6 (9) years and body mass index of 34.7 (4.5) kg/m. After propensity score adjusted multivariable analysis, patients who underwent VATS were >5-times more likely to experience conversion to thoracotomy than those who underwent RTS (odds ratio, 5.33; 95% CI, 4.14-6.81; P < .001). There was a linear association between the degree of obesity and odds ratio of VATS conversion to thoracotomy compared with RTS. VATS patients had a longer mean length of stay (5.0 vs 4.3 days, P < .001), higher rate of respiratory failure (2.8% [168 of 5975] vs 1.8% [39 of 2133], P = .026), and were less likely to be discharged to their home (92.5% [5525 of 5975] vs 94.3% [2012 of 2133]; P = .013) compared with RTS patients.
Conclusions: In obese patients, RTS anatomic lung resection is associated with a lower rate of conversion to thoracotomy than VATS.
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| http://dx.doi.org/10.1016/j.athoracsur.2021.09.061 | DOI Listing |
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