ArticleInterdisciplinary cardiovascular and thoracic surgery2026
Robotic Versus Video-Assisted Thoracoscopic Lobectomy/Segmentectomy: Multilevel Analysis in Japan.
Article in Interdisciplinary cardiovascular and thoracic surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Reply to Swaika et al.Interdisciplinary cardiovascular and thoracic surgery · 2026Article
- Methodological Considerations in Multilevel Comparative Analyses of Robotic Versus Video-Assisted Thoracoscopic Lung Resection.Interdisciplinary cardiovascular and thoracic surgery · 2026Article
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10 authors.
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No grant is acknowledged in the PubMed record.
Abstract
objectivesLarge-scale comparative data on the perioperative safety of robotic-assisted thoracoscopic surgery and video-assisted thoracoscopic surgery in Asia are limited. We compared the perioperative outcomes of these 2 approaches for lung cancer.
methodsThis retrospective study used data from the Diagnostic Procedure Combination database in Japan. We included 47 541 patients who underwent lobectomy or segmentectomy for lung cancer from 2018 to 2021 and performed multivariable analyses.
resultsAmong 47 541 patients, 2835 underwent robotic-assisted thoracoscopic surgery. Perioperative mortality did not differ significantly between groups (incidence rate ratio, 1.71; 95% CI, 0.88-3.33). Robotic-assisted surgery was associated with longer anaesthesia time and a higher incidence of mechanical ventilation postoperatively (incidence rate ratio, 1.96; 95% CI, 1.36-2.81), although the absolute difference was small (Marginal risk difference, +0.52 percentage points; 95% CI, +0.14 to +0.91). No significant differences were observed in other major complications, reoperation, or hospital stay.
conclusionsIn this large, real-world Japanese cohort including the early experience with robotic surgery, overall perioperative safety was comparable between robotic-assisted and video-assisted thoracoscopic surgery, although a statistically significant but small absolute increase in postoperative ventilation was observed with the robotic approach. This association remained robust across a series of sensitivity analyses. However, it is likely influenced by unmeasured confounding. Future prospective studies should investigate specific procedural factors, including anaesthetic management and patient selection, to optimize outcomes.
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