Eastern Cardiothoracic Surgical Society

Robotic Lobectomy: An Examination of Perioperative Outcomes in One-hundred and Fifty Consecutive Cases
Victor Reis, Kyle M. Langston, Kevin P. McGill, Michael F. Szwerc, Alex Werner,  Lehigh Valley Hospital Network, Allentown, PA

OBJECTIVE: Anatomic lung resection via thoracotomy is the standard of care for early stage non-small cell lung cancer however, in the last 25 years, minimally invasive approaches utilizing thoracoscopic and robotic platforms have been developed. This study examines a single center’s experience with robotic lobectomy.

METHODS: This is a retrospective analysis of a university-affiliated medical center’s experience with robotic lobectomy. All robotic lobectomies performed between 2011 and 2014 were examined. A total of 150 cases were found. Patient demographics analyzed were: age, sex, race and BMI. Our primary endpoint was operating room time. Secondary outcomes were: length of stay, 30-day morbidities and mortalities and conversion rates.

RESULTS: One-hundred fifty patients were underwent robotic lobectomy. Average age was 67.7 and BMI was 28. Most common pathology was adenocarcinoma (44%), average tumor size was 2.4 cm, average lymph nodes harvested was 12.2 and lymph node stations harvested was 5.1. Average OR time was 185 minutes, however, the time significantly decreased between the first fifty cases (218 min) and the last fifty cases (148 min). Length of stay also decreased from 3.5 days to 2.7 days. Conversion rates decreased from 18% to 10% between the first and last tertiles. Total complication rate was 40% with 8/59 considered major. Most common complications were persistent air leak, atrial fibrillation and urinary retention. There were no mortalities in our study.

CONCLUSIONS: Robotic lobectomy is a safe procedure. With experience, robotic lobectomy is associated with improved OR times, decreased conversion rates and decreased length of stay.