Robot-Assisted Lobectomy for Early-Stage Lung Cancer: Report of 100 Consecutive Cases

Farid - Gharagozloo, Marc Margolis, Barbara Tempesta, Eric Strother, Farzad Najam

Research output: Contribution to journalArticle

113 Citations (Scopus)

Abstract

Background: Robotics can facilitate dissection during video-assisted thoracoscopic (VATS) lobectomy. This study describes a hybrid minimally invasive lobectomy procedure consisting of two phases: robotic vascular, hilar, and mediastinal dissection, and then VATS lobectomy. Methods: Over a 54-month period, 100 consecutive patients with stage I and II (T1 or T2N0, and T1 or T2N1) lung cancer (42 men, 58 women; mean age 65 ± 8 years) underwent robotic VATS lobectomy. Results: Lobectomies were right upper (29), right middle (7), right lower (17), left upper (31), and left lower (16). Mean operating room time was 216 ± 27 minutes. Tumor type was adenocarcinoma (57), squamous cell carcinoma (25), 7 adenosquamous carcinoma (7), bronchoalveolar (3), large cell (1), poorly differentiated (3), carcinoid (2), mucoepidermoid (1), spindle cell (1). Pathologic upstaging was noted in 17 patients (10 to stage IIB, 7 to stage IIIA). There was no emergent conversion to a thoracotomy. Median hospitalization was 4 days. Complications included atrial fibrillation (13), atelectasis (5), prolonged air leak (4), pleural effusion (3), pulmonary embolus (3), incisional bleeding (1), hydropneumothorax (1), dural leak (1), liver failure (1), pneumonia (1), respiratory failure (1), and cardiopulmonary arrest (1). There was no intraoperative death. Postoperative mortality was 3%. There were no deaths among the last 80 patients. At a median follow-up of 32 months (range, 1 to 59), 1 patient (1%) died of his cancer, 6 (6%) had distant metastases, and 2 (2%) had a second lung primary cancer. There was no local recurrence. Conclusions: Robotics are feasible for mediastinal, hilar, and pulmonary vascular dissection during VATS lobectomy.

Original languageEnglish (US)
Pages (from-to)380-384
Number of pages5
JournalAnnals of Thoracic Surgery
Volume88
Issue number2
DOIs
StatePublished - Aug 2009
Externally publishedYes

Fingerprint

Robotics
Lung Neoplasms
Dissection
His-His-His-His-His-His
Blood Vessels
Hydropneumothorax
Adenosquamous Carcinoma
Lung
Pulmonary Atelectasis
Second Primary Neoplasms
Liver Failure
Carcinoid Tumor
Pleural Effusion
Thoracotomy
Operating Rooms
Heart Arrest
Embolism
Respiratory Insufficiency
Atrial Fibrillation
Squamous Cell Carcinoma

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery
  • Pulmonary and Respiratory Medicine

Cite this

Robot-Assisted Lobectomy for Early-Stage Lung Cancer : Report of 100 Consecutive Cases. / Gharagozloo, Farid -; Margolis, Marc; Tempesta, Barbara; Strother, Eric; Najam, Farzad.

In: Annals of Thoracic Surgery, Vol. 88, No. 2, 08.2009, p. 380-384.

Research output: Contribution to journalArticle

Gharagozloo, Farid - ; Margolis, Marc ; Tempesta, Barbara ; Strother, Eric ; Najam, Farzad. / Robot-Assisted Lobectomy for Early-Stage Lung Cancer : Report of 100 Consecutive Cases. In: Annals of Thoracic Surgery. 2009 ; Vol. 88, No. 2. pp. 380-384.
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abstract = "Background: Robotics can facilitate dissection during video-assisted thoracoscopic (VATS) lobectomy. This study describes a hybrid minimally invasive lobectomy procedure consisting of two phases: robotic vascular, hilar, and mediastinal dissection, and then VATS lobectomy. Methods: Over a 54-month period, 100 consecutive patients with stage I and II (T1 or T2N0, and T1 or T2N1) lung cancer (42 men, 58 women; mean age 65 ± 8 years) underwent robotic VATS lobectomy. Results: Lobectomies were right upper (29), right middle (7), right lower (17), left upper (31), and left lower (16). Mean operating room time was 216 ± 27 minutes. Tumor type was adenocarcinoma (57), squamous cell carcinoma (25), 7 adenosquamous carcinoma (7), bronchoalveolar (3), large cell (1), poorly differentiated (3), carcinoid (2), mucoepidermoid (1), spindle cell (1). Pathologic upstaging was noted in 17 patients (10 to stage IIB, 7 to stage IIIA). There was no emergent conversion to a thoracotomy. Median hospitalization was 4 days. Complications included atrial fibrillation (13), atelectasis (5), prolonged air leak (4), pleural effusion (3), pulmonary embolus (3), incisional bleeding (1), hydropneumothorax (1), dural leak (1), liver failure (1), pneumonia (1), respiratory failure (1), and cardiopulmonary arrest (1). There was no intraoperative death. Postoperative mortality was 3{\%}. There were no deaths among the last 80 patients. At a median follow-up of 32 months (range, 1 to 59), 1 patient (1{\%}) died of his cancer, 6 (6{\%}) had distant metastases, and 2 (2{\%}) had a second lung primary cancer. There was no local recurrence. Conclusions: Robotics are feasible for mediastinal, hilar, and pulmonary vascular dissection during VATS lobectomy.",
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T2 - Report of 100 Consecutive Cases

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AU - Margolis, Marc

AU - Tempesta, Barbara

AU - Strother, Eric

AU - Najam, Farzad

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AB - Background: Robotics can facilitate dissection during video-assisted thoracoscopic (VATS) lobectomy. This study describes a hybrid minimally invasive lobectomy procedure consisting of two phases: robotic vascular, hilar, and mediastinal dissection, and then VATS lobectomy. Methods: Over a 54-month period, 100 consecutive patients with stage I and II (T1 or T2N0, and T1 or T2N1) lung cancer (42 men, 58 women; mean age 65 ± 8 years) underwent robotic VATS lobectomy. Results: Lobectomies were right upper (29), right middle (7), right lower (17), left upper (31), and left lower (16). Mean operating room time was 216 ± 27 minutes. Tumor type was adenocarcinoma (57), squamous cell carcinoma (25), 7 adenosquamous carcinoma (7), bronchoalveolar (3), large cell (1), poorly differentiated (3), carcinoid (2), mucoepidermoid (1), spindle cell (1). Pathologic upstaging was noted in 17 patients (10 to stage IIB, 7 to stage IIIA). There was no emergent conversion to a thoracotomy. Median hospitalization was 4 days. Complications included atrial fibrillation (13), atelectasis (5), prolonged air leak (4), pleural effusion (3), pulmonary embolus (3), incisional bleeding (1), hydropneumothorax (1), dural leak (1), liver failure (1), pneumonia (1), respiratory failure (1), and cardiopulmonary arrest (1). There was no intraoperative death. Postoperative mortality was 3%. There were no deaths among the last 80 patients. At a median follow-up of 32 months (range, 1 to 59), 1 patient (1%) died of his cancer, 6 (6%) had distant metastases, and 2 (2%) had a second lung primary cancer. There was no local recurrence. Conclusions: Robotics are feasible for mediastinal, hilar, and pulmonary vascular dissection during VATS lobectomy.

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