Vol. 20 JA2016 - thoracic

T-09 – Launching a successful robotic thoracic surgery program: a focus on safety and quality in a learning curve setting

novembre 29, 2016
Auteur correspondant : Henri de Lesquen

Henri de Lesquen, Ilies Bouabdallah, Diane Mège, Joséphine Chenesseau, Charles-Henri David, Bastien Orsini, Lucile Gust, Geoffrey Brioude, Delphine Trousse, Xavier-Benoît D’Journo, Christophe Doddoli, Pascal-Alexandre Thomas

Institution : Service de chirurgie thoracique et maladies de l’œsophage, hôpital Nord, AP-HM, Marseille

Objectives : The purpose of this study was to compare our initial experience with RATS pulmonary lobectomy with that of our well-established VATS program.

Methods : We compared the early outcomes of those 76 patients having had a 3-port full thoracoscopic lobectomy performed by the most experienced VATS surgeon with those 87 patients having had a 3-arm RATS lobectomy performed by a single surgeon during a 24-month period.

Results : Operative time was longer in the RATS group (mean: 134.5 ±154.2 vs 37,7 min ±47.3 min, p=0.004). Overall morbidity was similar (43.4% vs 39.1%, p=0.57). Five patients in the VATS group required blood transfusions and only one in the RATS group (P=0.12). Readmission rates at 90 days were similar (3.9% vs 6.9%; P=0.38). The 90-day mortality rates were 2.6% and 0% (P=0.12). More N2 nodes were removed in the VATS group (mean: 9.92 ±5.41 vs 6.24 ±5.584, p<0.0001). The proportion of lymph node upstaging was similar in both groups (16% vs 13%; p=0.65).

Conclusion : Early experience with RATS pulmonary lobectomy appears to be as safe as mature VATS cases as regards to the 90-day post operative period.