Robotic sleeve lobectomy for centrally located non-small cell lung cancer: a propensity score weighted comparison with thoracoscopic and open surgery

Abstract Objective This study aimed to evaluate the surgical and oncologic outcomes of robotic sleeve lobectomy in comparison with video-assisted thoracoscopic surgery (VATS) and open surgery. Methods Surgical outcomes in patients with non-small cell lung cancer (NSCLC) who underwent sleeve lobectomy via robotic, VATS and thoracotomy were assessed using Chi-square test, Fisher’s exact test, and Kruskal-Wallis rank sum test. Log-rank test and Cox proportional hazards model were used in survival analyses. Propensity score weighted matching was used to achieve the balance of baseline among the three groups. Results Between 2012 and 2017, 188 patients were included and divided into robotic (n=49), VATS (n=73) and open (n=66) group. After weighted matching that retained all patients, no statistical difference in ninety-day mortality or morbidity among the three groups was shown. Patients in the robotic group had less bleeding loss (P 0.050). Conclusions Robotic sleeve lobectomy is a safe, feasible and effective procedure. Compared with VATS and open techniques, robotic sleeve lobectomy has a similar oncologic prognosis for patients with centrally located NSCLC. Further studies with larger sample size and long-term follow-up are needed.