ArticleFrontiers in oncology2026
Perioperative outcomes of robot-assisted versus video-assisted thoracoscopic surgery for non-small cell lung cancer: a meta-analysis focusing on real-world clinical studies in the past 10 years.
Article in Frontiers in oncology, 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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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Abstract
Objective: Non-small cell lung cancer (NSCLC) accounts for more than 80% of lung cancer cases, and minimally invasive lobectomy is a standard curative approach for early-stage disease. The comparative perioperative outcomes of Robot-assisted thoracoscopic surgery (RATS) and Video-assisted thoracoscopic surgery (VATS) remain controversial. This meta-analysis compared perioperative outcomes of RATS and VATS for NSCLC using real-world clinical studies while excluding database-based analyses to better reflect routine practice. Methods: PubMed, Embase, the Cochrane Library, and Web of Science were searched for English-language studies published from January 2016 to December 2025. Eligible studies were real-world clinical reports directly comparing RATS with VATS in NSCLC; database analyses and clinical trials were excluded. Two reviewers independently screened studies and extracted data. Study quality was assessed using the Newcastle-Ottawa Scale (NOS). Meta-analysis was performed with Review Manager 5.3. Results: Nine studies were included (7 high-quality and 2 moderate-quality), involving 2, 130 patients with NSCLC (RATS: 1, 090; VATS: 1, 040). Pooled analyses showed no significant differences between RATS and VATS in intraoperative blood loss, postoperative length of stay, or postoperative complication rates. RATS was associated with a higher lymph node yield than VATS (weighted mean difference, +2.38). In the lobectomy subgroup, operative time and postoperative length of stay were shorter with RATS. Funnel plots did not suggest substantial publication bias. Conclusion: Based on real-world clinical evidence, RATS and VATS achieve comparable perioperative safety and short-term outcomes in NSCLC. RATS is associated with greater lymph node retrieval and may be a reasonable option when nodal yield is prioritized, particularly for patients undergoing lobectomy.
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