Robotic Pneumonectomy for Lung Cancer: Perioperative Outcomes and Factors Leading to Conversion to Thoracotomy

Byron D. Patton, Daniel Zarif, Donna M. Bahroloomi, Iam C. Sarmiento, Paul C. Lee, Richard S. Lazzaro

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Objective: In the tide of robot-assisted minimally invasive surgery, few cases of robot-assisted pneumonectomy exist in the literature. This study evaluates the perioperative outcomes and risk factors for conversion to thoracotomy with an initial robotic approach to pneumonectomy for lung cancer. Methods: This study is a single-center retrospective review of all pneumonectomies for lung cancer with an initial robotic approach between 2015 and 2019. Patients were divided into 2 groups: surgeries completed robotically and surgeries converted to thoracotomy. Patient demographics, preoperative clinical data, surgical pathology, and perioperative outcomes were compared for meaningful differences between the groups. Results: Thirteen total patients underwent robotic pneumonectomy with 8 of them completed robotically and 5 converted to thoracotomy. There were no significant differences in patient characteristics between the groups. The Robotic group had a shorter operative time (P < 0.01) and less estimated blood loss (P = 0.02). There were more lymph nodes harvested in the Robotic group (P = 0.08) but without statistical significance. There were 2 major complications in the Robotic group and none in the Conversion group. Neither tumor size nor stage were predictive of conversion to thoracotomy. Conversions decreased over time with a majority occurring in the first 2 years. There were no conversions for bleeding and no mortalities. Conclusions: Robotic pneumonectomy for lung cancer is a safe procedure and a reasonable alternative to thoracotomy. With meticulous technique, major bleeding can be avoided and most procedures can be completed robotically. Larger studies are needed to elucidate any advantages of a robotic versus open approach.

Original languageEnglish
Pages (from-to)136-141
Number of pages6
JournalInnovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
Volume16
Issue number2
DOIs
StatePublished - Mar 2021
Externally publishedYes

Keywords

  • lung cancer
  • outcomes
  • pneumonectomy
  • robotic
  • thoracotomy

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