ArticleSurgical endoscopy2026
Reduced incidence of significant vessel injury in robotic-assisted thoracic surgery compared with video-assisted thoracic surgery.
Article in Surgical endoscopy, 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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4 authors.
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Abstract
backgroundThis study compared the incidence of intraoperative significant vessel injury between robotic-assisted thoracic surgery (RATS) and video-assisted thoracic surgery (VATS) during major pulmonary resection.
methodsThis retrospective study included 1215 patients who underwent major pulmonary resection via a minimally invasive approach between October 2012 and August 2025 at our institution: 903 underwent VATS (413 uniport, 490 multiport) and 312 underwent RATS. Propensity scores were calculated using preoperative variables, and stabilized inverse probability of treatment weighting (IPTW) was applied. The primary outcome was intraoperative significant vessel injury, defined as bleeding that required additional hemostatic intervention, such as sealant application, clipping, or suturing, after initial compression. Weighted logistic regression was used to assess the association between surgical approach and significant vessel injury. Secondary perioperative outcomes were also compared.
resultsAfter IPTW adjustment, baseline characteristics were well balanced. RATS was associated with a significantly lower risk of intraoperative significant vessel injury than VATS (adjusted odds ratio [OR]: 0.21, 95% confidence interval [CI], 0.08-0.54, P = 0.001). In an exploratory three-group analysis, RATS showed a lower risk than multiport VATS (OR: 0.15, 95% CI: 0.06-0.40, P < 0.001) and a borderline lower risk than uniport VATS (OR: 0.35, 95% CI: 0.12-1.00, P = 0.050). RATS was also associated with more favorable perioperative outcomes.
conclusionsRATS was associated with a lower risk of intraoperative significant vessel injury than VATS and with favorable short-term perioperative outcomes during major pulmonary resection.
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