PMID- 31522428
OWN - NLM
STAT- MEDLINE
DCOM- 20211123
LR  - 20211123
IS  - 1439-1902 (Electronic)
IS  - 0171-6425 (Linking)
VI  - 69
IP  - 6
DP  - 2021 Sep
TI  - Successful Sleeve Resection as a Marker for Proficiency for Robotic Pulmonary 
      Resection.
PG  - 551-556
LID - 10.1055/s-0039-1696952 [doi]
AB  - BACKGROUND:  Robot technology is a revolutionary technique to overcome 
      limitations of minimal invasive surgery. The proficiency level varies from study 
      to study. We considered the first sleeve lobectomy as a benchmark procedure to 
      evaluate the proficiency level. METHODS:  We retrospectively analyzed 197 
      patients who underwent robot-assisted thoracoscopic surgery (RATS) for primary 
      lung cancer between December 2011 and May 2018. Patients were divided into two 
      groups based on undergoing surgery earlier period (EP) or later period (LP) than 
      the first sleeve lobectomy by RATS (May 25, 2015). The preoperative, operative, 
      and short- and long-term postoperative outcomes were compared. Seven-year 
      survival was also compared between two periods for T1N0 and T2N0 diseases. 
      RESULTS:  Preoperative features were similar. The mean operative time was 
      166.8 +/- 55.1 and 142.4 +/- 43.9 minutes in EP and LP, respectively (p = 0.005). The 
      mean number of dissected lymph nodes in LP was also significantly higher than 
      that in EP (24.4 +/- 9.4 vs. 20.8 +/- 10.4, p = 0.035). The complication rate was 
      significantly lower in LP (29/86 vs. 25/111, p = 0.048). The extended resection 
      (ER) rate was significantly higher in LP (p = 0.023). The 7-year survival was 
      comparable in EP and LP in both patients with T1N0 and T2N0 (p = 0.28 and 
      p = 0.11, respectively). CONCLUSION:  Perioperative outcomes, such as duration of 
      surgery, number of dissected lymph nodes, complications, and ERs are favorable in 
      patients who underwent surgeries after the first sleeve resection. The first 
      sleeve lobectomy may be considered as the benchmark procedure for the proficiency 
      level in RATS.
CI  - Thieme. All rights reserved.
FAU - Cosgun, Tugba
AU  - Cosgun T
AD  - Department of Thoracic Surgery, Demiroglu Bilim University, Istanbul, Turkey.
FAU - Kaba, Erkan
AU  - Kaba E
AD  - Department of Thoracic Surgery, Demiroglu Bilim University, Istanbul, Turkey.
FAU - Ayalp, Kemal
AU  - Ayalp K
AD  - Istanbul Florence Nightingale Hospital, Istanbul, Turkey.
FAU - Toker, Alper
AU  - Toker A
AD  - Istanbul Florence Nightingale Hospital, Istanbul, Turkey.
LA  - eng
PT  - Journal Article
DEP - 20190915
PL  - Germany
TA  - Thorac Cardiovasc Surg
JT  - The Thoracic and cardiovascular surgeon
JID - 7903387
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Benchmarking
MH  - Female
MH  - Humans
MH  - Lung Neoplasms/mortality/pathology/*surgery
MH  - Male
MH  - Middle Aged
MH  - Neoplasm Staging
MH  - *Pneumonectomy/adverse effects/mortality
MH  - Postoperative Complications/etiology
MH  - Quality Indicators, Health Care
MH  - Retrospective Studies
MH  - *Robotic Surgical Procedures/adverse effects/mortality
MH  - *Thoracoscopy/adverse effects/mortality
MH  - Time Factors
MH  - Treatment Outcome
MH  - Young Adult
COIS- The authors have no conflict of interest to declare.
EDAT- 2019/09/16 06:00
MHDA- 2021/11/24 06:00
CRDT- 2019/09/16 06:00
PHST- 2019/09/16 06:00 [pubmed]
PHST- 2021/11/24 06:00 [medline]
PHST- 2019/09/16 06:00 [entrez]
AID - 10.1055/s-0039-1696952 [doi]
PST - ppublish
SO  - Thorac Cardiovasc Surg. 2021 Sep;69(6):551-556. doi: 10.1055/s-0039-1696952. Epub 
      2019 Sep 15.