Robotic-Assisted Lobectomy Favors Early Lung Recovery versus Limited Thoracotomy.
(2021) The Thoracic and Cardiovascular Surgeon — Vol. 69, n° 6, p. 557-563 (2021)
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- (en) BACKGROUND: Postoperative pulmonary recovery after lobectomy has showed early benefits for the video-assisted thoracoscopic surgery and sparing open techniques over nonsparing techniques. Robotic-assisted procedures offer benefits in term of clinical outcomes, but their advantages on pulmonary recovery and quality of life have not yet been distinctly prospectively studied. METHODS: Eighty-six patients undergoing lobectomy over a period of 29 months were prospectively studied for their pulmonary function recovery and pain score level during the in-hospital stay and at 1, 2, and 6 months. Quality of life was evaluated at 2 and 6 months. Forty-five patients were operated by posterolateral limited thoracotomy and 41 patients by robotic approach. The postoperative analgesia protocol differed for the two groups, being lighter for the robotic group. RESULTS: The pulmonary tests were not significantly different during the in-hospital stay. At 1 month, the forced expiratory volume in 1 second, forced vital capacity, vital capacity, and maximal expiratory pressure were significantly better for the robotic group (p = 0.05, 0.04, 0.05, and 0.02, respectively). There was no significant difference left at 2 and 6 months. Pain intensity was equivalent during the in-hospital stay but was significantly lower for the robotic group at 1 month (p = 0.02). At 2 and 6 months, pain and quality of life were comparable. CONCLUSION: Robotic technique can offer similar pulmonary and pain recovery during the in-hospital stay with a lighter analgesia protocol. It clearly favors the early term recovery compared with the open limited technique. The objective and subjective functional recovery becomes equivalent at 2 and 6 months.
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Lacroix, V., Kahn, D., Matte, P., Pieters, T., Noirhomme, P., Poncelet, A., & Steyaert, A. (2021). Robotic-Assisted Lobectomy Favors Early Lung Recovery versus Limited Thoracotomy. The Thoracic and Cardiovascular Surgeon, 69(6), 557-563. https://doi.org/10.1055/s-0040-1715598 (Original work published 2021)