PMID- 35832453
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220716
IS  - 2218-6751 (Print)
IS  - 2226-4477 (Electronic)
IS  - 2218-6751 (Linking)
VI  - 11
IP  - 6
DP  - 2022 Jun
TI  - Comparison of the perioperative outcomes between robotic-assisted thoracic 
      surgery and video-assisted thoracic surgery in non-small cell lung cancer 
      patients with different body mass index ranges.
PG  - 1108-1118
LID - 10.21037/tlcr-22-137 [doi]
AB  - BACKGROUND: Non-small cell lung cancer (NSCLC) is the most common malignancy and 
      one of the most common causes of cancer-related death worldwide. Robotic-assisted 
      thoracic surgery (RATS) has gradually become a prevalent surgical method for 
      patients with NSCLC. Previous studies have found that body mass index (BMI) is 
      associated with postoperative outcomes. This study aimed to investigate the 
      effectiveness of RATS compared to video-assisted thoracic surgery (VATS) in the 
      treatment of NSCLC with different BMI, in terms of perioperative outcomes. 
      METHODS: The baseline and perioperative data, including BMI, of 849 NSCLC 
      patients who underwent minimally invasive anatomic lung resections from August 
      2020 to April 2021 were retrospectively collected and analyzed. Propensity score 
      matching analysis was applied to minimize potential bias between the two groups 
      (VATS and RATS), and the perioperative outcomes were compared. Subgroup analysis 
      was subsequently performed. RESULTS: Compared to VATS, RATS had more lymph nodes 
      dissected 9 [inter-quartile range (IQR), 6-12] vs. 7 (IQR, 6-10), P<0.001, a 
      lower estimated bleeding volume [40 (IQR, 30-50) vs. 50 (IQR, 40-60) mL, 
      P<0.001], and other better postoperative outcomes, but a higher cost of 
      hospitalization [ yen83,626 (IQR, 77,211-92,686) vs.  yen75,804 (IQR, 66,184-83,693), 
      P<0.001]. Multivariable logistic regression analysis indicated that RATS 
      (P=0.027) and increasing BMI (P=0.030) were associated with a statistically 
      significant reduction in the risk of postoperative complications. Subgroup 
      analysis indicated that the advantages of RATS may be more obvious in patients 
      with a BMI of 24-28 kg/m(2), in which the RATS group had more lymph nodes 
      dissected [9 (IQR, 6-12) vs. 7 (IQR, 5-10), P<0.001] and a decreased risk of 
      total postoperative complications [odds ratio (OR), 0.443; 95% confidence 
      interval (CI), 0.212-0.924; P=0.030] compared to the VATS group. CONCLUSIONS: 
      Both, RATS and VATS can be safely applied for patients with NSCLC. Perioperative 
      outcome parameters indicate advantages for RATS, however at a higher cost of 
      hospitalization. The advantages of RATS might be more obvious in patients with a 
      BMI of 24-28 kg/m(2).
CI  - 2022 Translational Lung Cancer Research. All rights reserved.
FAU - Qu, Chenghao
AU  - Qu C
AD  - Department of Thoracic Surgery, Qilu Hospital of Shandong University, Jinan, 
      China.
FAU - Li, Rongyang
AU  - Li R
AD  - Department of Thoracic Surgery, Qilu Hospital of Shandong University, Jinan, 
      China.
FAU - Ma, Zheng
AU  - Ma Z
AD  - Department of Thoracic Surgery, Qilu Hospital of Shandong University, Jinan, 
      China.
FAU - Han, Jingyi
AU  - Han J
AD  - Department of Thoracic Surgery, Qilu Hospital of Shandong University, Jinan, 
      China.
FAU - Yue, Weiming
AU  - Yue W
AD  - Department of Thoracic Surgery, Qilu Hospital of Shandong University, Jinan, 
      China.
FAU - Aigner, Clemens
AU  - Aigner C
AD  - Department of Thoracic Surgery, Ruhrlandklinik, University Medicine Essen, Essen, 
      Germany.
FAU - Casiraghi, Monica
AU  - Casiraghi M
AD  - Division of Thoracic Surgery, European Institute of Oncology-IEO IRCCS, Milan, 
      Italy.
AD  - Department of Oncology and Hemato-Oncology (DIPO), University of Milan, Milan, 
      Italy.
FAU - Tian, Hui
AU  - Tian H
AD  - Department of Thoracic Surgery, Qilu Hospital of Shandong University, Jinan, 
      China.
LA  - eng
PT  - Journal Article
PL  - China
TA  - Transl Lung Cancer Res
JT  - Translational lung cancer research
JID - 101646875
PMC - PMC9271441
OTO - NOTNLM
OT  - Non-small cell lung cancer (NSCLC)
OT  - body mass index (BMI)
OT  - robotic-assisted thoracic surgery (RATS)
OT  - video-assisted thoracic surgery (VATS)
COIS- Conflicts of Interest: All authors have completed the ICMJE uniform disclosure 
      form (available at 
      https://tlcr.amegroups.com/article/view/10.21037/tlcr-22-137/coif). The authors 
      have no conflicts of interest to declare.
EDAT- 2022/07/15 06:00
MHDA- 2022/07/15 06:01
PMCR- 2022/06/01
CRDT- 2022/07/14 02:23
PHST- 2022/03/14 00:00 [received]
PHST- 2022/06/16 00:00 [accepted]
PHST- 2022/07/14 02:23 [entrez]
PHST- 2022/07/15 06:00 [pubmed]
PHST- 2022/07/15 06:01 [medline]
PHST- 2022/06/01 00:00 [pmc-release]
AID - tlcr-11-06-1108 [pii]
AID - 10.21037/tlcr-22-137 [doi]
PST - ppublish
SO  - Transl Lung Cancer Res. 2022 Jun;11(6):1108-1118. doi: 10.21037/tlcr-22-137.