Optimizing surgical precision: a comparative study of three-port vs. four-port robotic-assisted lobectomy for NSCLC

Abstract Background In recent years, robot-assisted thoracoscopic surgery has seen major advances. The feasibility and safety of this new surgical procedure have been widely recognized. However, only a few studies have investigated the short-term postoperative outcomes of lobectomy in early-stage no...

Full description

Saved in:
Bibliographic Details
Main Authors: Fangfang Yang, Lei Chen, Hui Wang, Qianyun Wang, Chen Yang
Format: Article
Language:English
Published: BMC 2025-04-01
Series:Journal of Cardiothoracic Surgery
Subjects:
Online Access:https://doi.org/10.1186/s13019-025-03436-4
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849726455055908864
author Fangfang Yang
Lei Chen
Hui Wang
Qianyun Wang
Chen Yang
author_facet Fangfang Yang
Lei Chen
Hui Wang
Qianyun Wang
Chen Yang
author_sort Fangfang Yang
collection DOAJ
description Abstract Background In recent years, robot-assisted thoracoscopic surgery has seen major advances. The feasibility and safety of this new surgical procedure have been widely recognized. However, only a few studies have investigated the short-term postoperative outcomes of lobectomy in early-stage non-small cell lung cancer (NSCLC) patients using different numbers of ports in Da Vinci robot-assisted surgery. This study aimed to evaluate the clinical value of robot-assisted lobectomy by comparing the perioperative data of NSCLC patients who underwent three-port and four-port surgical methods. Methods The data of 121 consecutive patients who were admitted to our hospital for NSCLC and underwent Da Vinci robot-assisted thoracic surgery (RATS) for radical resection from January 2020 to October 2021 were retrospectively collected and analyzed. The cases that did not meet the inclusion criteria were removed, and the patients were divided into the three-port group (76 cases) and the four-port group (45 cases). The general clinical data, perioperative data, and postoperative pain were individually compared to determine the different clinical effectiveness of the two approaches. Results All 121 patients in the 2 groups successfully underwent lobectomy and systemic lymph node dissection. No significant difference in age, sex, tumor location, tumor size, history of chronic disease, pathological type, pathological tumor-node-metastasis (pTNM) staging, postoperative complications, and number or stations of total lymph nodes dissected was observed between the two groups (P > 0.05). The operation time [(117.32 ± 36.55) min vs. (136.83 ± 40.63) min], the console time [(90 ± 19.35) min vs. (103 ± 15.65) min], the intraoperative blood loss [(94.34 ± 32.16) mL vs. (102.73 ± 33.67) mL], the chest tube drainage time [(2.43 ± 0.65) d vs. (2.79 ± 1.42) d], and the postoperative hospitalization time [(4.55 ± 1.43) d vs. (5.14 ± 1.66) d] were lower in the three-port group compared to the four-port group but showed no statistically significant difference (P > 0.05). However, the three-port group demonstrated significantly superior visual analogue scale pain scores compared to the four-port group at 24, 48, and 72 h postoperatively (all p < 0.001). Conclusions Compared to four-port RATS, the three-port robotic-assisted lobectomy is safe, practicable and effective. Operative incision optimization leads to less postoperative pain and appears to be more acceptable for patients with NSCLC.
format Article
id doaj-art-3bee0de683314dfd8653c8ecd1309435
institution DOAJ
issn 1749-8090
language English
publishDate 2025-04-01
publisher BMC
record_format Article
series Journal of Cardiothoracic Surgery
spelling doaj-art-3bee0de683314dfd8653c8ecd13094352025-08-20T03:10:10ZengBMCJournal of Cardiothoracic Surgery1749-80902025-04-012011810.1186/s13019-025-03436-4Optimizing surgical precision: a comparative study of three-port vs. four-port robotic-assisted lobectomy for NSCLCFangfang Yang0Lei Chen1Hui Wang2Qianyun Wang3Chen Yang4Department of Medical Services Section, The First People’s Hospital of Changzhou, The Third Affiliated Hospital of Soochow UniversityDepartment of Thoracic Surgery, The First People’s Hospital of Changzhou, The Third Affiliated Hospital of Soochow UniversityDepartment of Pathology, The First People’s Hospital of Changzhou, The Third Affiliated Hospital of Soochow UniversityDepartment of Thoracic Surgery, The First People’s Hospital of Changzhou, The Third Affiliated Hospital of Soochow UniversityDepartment of Thoracic Surgery, The First People’s Hospital of Changzhou, The Third Affiliated Hospital of Soochow UniversityAbstract Background In recent years, robot-assisted thoracoscopic surgery has seen major advances. The feasibility and safety of this new surgical procedure have been widely recognized. However, only a few studies have investigated the short-term postoperative outcomes of lobectomy in early-stage non-small cell lung cancer (NSCLC) patients using different numbers of ports in Da Vinci robot-assisted surgery. This study aimed to evaluate the clinical value of robot-assisted lobectomy by comparing the perioperative data of NSCLC patients who underwent three-port and four-port surgical methods. Methods The data of 121 consecutive patients who were admitted to our hospital for NSCLC and underwent Da Vinci robot-assisted thoracic surgery (RATS) for radical resection from January 2020 to October 2021 were retrospectively collected and analyzed. The cases that did not meet the inclusion criteria were removed, and the patients were divided into the three-port group (76 cases) and the four-port group (45 cases). The general clinical data, perioperative data, and postoperative pain were individually compared to determine the different clinical effectiveness of the two approaches. Results All 121 patients in the 2 groups successfully underwent lobectomy and systemic lymph node dissection. No significant difference in age, sex, tumor location, tumor size, history of chronic disease, pathological type, pathological tumor-node-metastasis (pTNM) staging, postoperative complications, and number or stations of total lymph nodes dissected was observed between the two groups (P > 0.05). The operation time [(117.32 ± 36.55) min vs. (136.83 ± 40.63) min], the console time [(90 ± 19.35) min vs. (103 ± 15.65) min], the intraoperative blood loss [(94.34 ± 32.16) mL vs. (102.73 ± 33.67) mL], the chest tube drainage time [(2.43 ± 0.65) d vs. (2.79 ± 1.42) d], and the postoperative hospitalization time [(4.55 ± 1.43) d vs. (5.14 ± 1.66) d] were lower in the three-port group compared to the four-port group but showed no statistically significant difference (P > 0.05). However, the three-port group demonstrated significantly superior visual analogue scale pain scores compared to the four-port group at 24, 48, and 72 h postoperatively (all p < 0.001). Conclusions Compared to four-port RATS, the three-port robotic-assisted lobectomy is safe, practicable and effective. Operative incision optimization leads to less postoperative pain and appears to be more acceptable for patients with NSCLC.https://doi.org/10.1186/s13019-025-03436-4Robot-assisted thoracic surgery (RATS)LobectomyThree PortFour PortNon-small cell lung cancer (NSCLC)
spellingShingle Fangfang Yang
Lei Chen
Hui Wang
Qianyun Wang
Chen Yang
Optimizing surgical precision: a comparative study of three-port vs. four-port robotic-assisted lobectomy for NSCLC
Journal of Cardiothoracic Surgery
Robot-assisted thoracic surgery (RATS)
Lobectomy
Three Port
Four Port
Non-small cell lung cancer (NSCLC)
title Optimizing surgical precision: a comparative study of three-port vs. four-port robotic-assisted lobectomy for NSCLC
title_full Optimizing surgical precision: a comparative study of three-port vs. four-port robotic-assisted lobectomy for NSCLC
title_fullStr Optimizing surgical precision: a comparative study of three-port vs. four-port robotic-assisted lobectomy for NSCLC
title_full_unstemmed Optimizing surgical precision: a comparative study of three-port vs. four-port robotic-assisted lobectomy for NSCLC
title_short Optimizing surgical precision: a comparative study of three-port vs. four-port robotic-assisted lobectomy for NSCLC
title_sort optimizing surgical precision a comparative study of three port vs four port robotic assisted lobectomy for nsclc
topic Robot-assisted thoracic surgery (RATS)
Lobectomy
Three Port
Four Port
Non-small cell lung cancer (NSCLC)
url https://doi.org/10.1186/s13019-025-03436-4
work_keys_str_mv AT fangfangyang optimizingsurgicalprecisionacomparativestudyofthreeportvsfourportroboticassistedlobectomyfornsclc
AT leichen optimizingsurgicalprecisionacomparativestudyofthreeportvsfourportroboticassistedlobectomyfornsclc
AT huiwang optimizingsurgicalprecisionacomparativestudyofthreeportvsfourportroboticassistedlobectomyfornsclc
AT qianyunwang optimizingsurgicalprecisionacomparativestudyofthreeportvsfourportroboticassistedlobectomyfornsclc
AT chenyang optimizingsurgicalprecisionacomparativestudyofthreeportvsfourportroboticassistedlobectomyfornsclc