Robot- vs. Video-assisted Thoracoscopic Lobectomy for Early Lung Cancer
Menée aux Etats-Unis à partir de données du registre national des cancers portant sur 18 908 patients atteints d'un cancer du poumon non à petites cellules de stade I traité entre 2010 et 2014, cette étude compare, du point de vue de la mortalité, l'intérêt d'une lobectomie thoracoscopique vidéo-assistée et d'une lobectomie thoracoscopique assistée par robot
Robot-assisted thoracoscopicsurgery (RATS) is increasingly considered an alternative to video-assisted thoracoscopic surgery (VATS) and thoracotomy for patients with resectable non-small cell lung cancer (NSCLC). RATS has several potential advantages compared to VATS, including increased intraoperative rotational capacity, three-dimensional visualization, a shorter hospitalization, and improved postoperative analgesia, though these have not been demonstrated uniformly or in prospective, randomized trials. However, RATS has been associated with increased costs and early reports revealed a potentially increased risk of cardiovascular complications compared to VATS. Further, the comparative oncologic effectiveness of RATS compared to VATS has not been demonstratedin prospective trials, although single institution and registry analyses have demonstrated similar survival in patients undergoing lobectomy with either approach.
JNCI Cancer Spectrum , éditorial en libre accès, 2019