ArticleJournal of thoracic disease2026
Efficacy of Da Vinci robot-assisted thoracoscopic surgery combined with three-dimensional imaging for precisive segmentectomy in stage IA non-small cell lung cancer ≤2 cm: a retrospective cohort study.
Article in Journal of thoracic disease, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: With the increasing use of low-dose computed tomography (LDCT), the detection rate of early-stage non-small cell lung cancer (NSCLC) with tumors ≤2 cm has significantly risen. While lobectomy remains the standard treatment, it may compromise postoperative pulmonary function. Segmentectomy offers a function-preserving alternative, yet poses greater technical challenges. This study aimed to evaluate the safety and efficacy of robot-assisted thoracoscopic surgery (RATS) combined with three-dimensional imaging technology for precise anatomical segmentectomy in patients with stage IA NSCLC ≤2 cm. Methods: This retrospective study included 184 patients with stage IA NSCLC (T1a-1bN0M0) treated between October 2021 and October 2024. Patients were divided into two groups: Group A (video-assisted thoracoscopic segmentectomy, n=96) and Group B (RATS with three-dimensional imaging, n=88). Perioperative outcomes, postoperative complications, and pulmonary function at 6 months were compared. Results: Although Group B had a longer operative time (P<0.05), it showed significant advantages in the number and stations of lymph nodes dissected, shorter chest tube duration and hospital stay (P<0.05). Although the incidence of prolonged air leak (>5 days) was not statistically significant between the two groups, group B showed a lower incidence. At 6 months postoperatively, Group B had significantly better preserved pulmonary function [forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), peak expiratory flow (PEF); P<0.05]. Conclusions: Robot-assisted segmentectomy guided by three-dimensional imaging is safe and feasible for patients with stage IA NSCLC. Compared with conventional video-assisted thoracoscopic surgery, this technique offers superior preservation of pulmonary function and a lower incidence of postoperative air leakage, highlighting its potential for broader clinical application.
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