Short-term outcomes of mini-thoracotomy, multiportal video-assisted thoracic surgery, and multiportal robot-assisted thoracic surgery for complex segmentectomy.
- 1Department of Thoracic Surgery, Kanagawa Cancer Center, 2-3-2 Nakao, Asahi, Yokohama, 241-8515, Kanagawa, Japan. [email protected].
- 2Department of Thoracic Surgery, Kanagawa Cancer Center, 2-3-2 Nakao, Asahi, Yokohama, 241-8515, Kanagawa, Japan.
Abstract
This study examined the association of surgical approach with operative and postoperative outcomes as well as margin and nodal outcomes after complex segmentectomy, comparing mini-thoracotomy (MT) with multiportal minimally invasive thoracic surgery (mMITS) and, within mMITS, video-assisted thoracic surgery (mVATS) with multiportal robot-assisted thoracic surgery (mRATS), using propensity score matching (PSM). The study cohort comprised 808 consecutive patients treated with complex segmentectomy for suspected malignant pulmonary tumors from January 2015 through July 2026. Of these, 138 underwent MT and 670 mMITS, including 605 mVATS and 65 mRATS. PSM (1:2) was performed for MT versus mMITS (n = 126 vs. 252) and mVATS versus mRATS (n = 126 vs. 63). We assessed operative outcomes, postoperative complications, pain-related outcomes only for the mVATS-mRATS comparison, and margin and nodal outcomes. Blood loss was lower with mMITS than with MT (5 vs. 20 mL, p < 0.001), and chest tube duration was shorter (p = 0.002). Margin and nodal outcomes did not differ significantly between MT and mMITS. mRATS was associated with less blood loss than mVATS (3 vs. 5 mL, p = 0.006), a shorter duration of regular oral analgesic use (20 vs. 31 days, p = 0.007), and greater hilar and mediastinal lymph node yields (hilar, p = 0.037; mediastinal, p = 0.025). For complex segmentectomy, mMITS was associated with less blood loss and shorter chest tube duration than MT, without significant differences in margin and nodal outcomes. Within mMITS, mRATS was associated with shorter regular oral analgesic use and greater hilar and mediastinal lymph node yields than mVATS.
Related
- From Thoracotomy to Robotic Platforms in Thoracic Surgery: Technical Evolution, Simulation-Based Training, and Surgical Outcomes.
- Thoracic endovascular aortic repair-first hybrid repair without thoracotomy for type V thoracoabdominal aortic aneurysm
- Comparative efficacy of uniportal and multiportal robotic-assisted thoracoscopic surgery for non-small cell lung cancer: a systematic review and meta-analysis
- Radiation-Associated Lung Adenosquamous Carcinoma Diagnosed by Robotic-Assisted Bronchoscopy With Cone-Beam CT Guidance and Treated With Robotic Superior Segmentectomy: A Case Report
- Current Status, Clinical Outcomes and Socioeconomic Challenges of Uniportal Video-Assisted Thoracoscopic Surgery in Japan Compared with Robot-Assisted Thoracic Surgery: A Narrative Review
BibTeX
@article{isaka2026shortterm,
title = {{Short-term outcomes of mini-thoracotomy, multiportal video-assisted thoracic surgery, and multiportal robot-assisted thoracic surgery for complex segmentectomy.}},
author = {Tetsuya Isaka and Gentaro Murata and Naoki Nishina and Makoto Ogata and Ikki Takada and Chiaki Kanno and Takuya Nagashima and Hiroyuki Ito},
journal = {Journal of robotic surgery},
year = {2026},
month = oct,
doi = {10.1007/s11701-026-04088-9},
url = {https://europepmc.org/article/MED/42909739},
note = {CC BY},
}
RIS
TY - JOUR
TI - Short-term outcomes of mini-thoracotomy, multiportal video-assisted thoracic surgery, and multiportal robot-assisted thoracic surgery for complex segmentectomy.
AU - Tetsuya Isaka
AU - Gentaro Murata
AU - Naoki Nishina
AU - Makoto Ogata
AU - Ikki Takada
AU - Chiaki Kanno
AU - Takuya Nagashima
AU - Hiroyuki Ito
PY - 2026
DA - 2026/10/23
JO - Journal of robotic surgery
DO - 10.1007/s11701-026-04088-9
UR - https://europepmc.org/article/MED/42909739
AB - This study examined the association of surgical approach with operative and postoperative outcomes as well as margin and nodal outcomes after complex segmentectomy, comparing mini-thoracotomy (MT) with multiportal minimally invasive thoracic surgery (mMITS) and, within mMITS, video-assisted thoracic surgery (mVATS) with multiportal robot-assisted thoracic surgery (mRATS), using propensity score matching (PSM). The study cohort comprised 808 consecutive patients treated with complex segmentectomy for suspected malignant pulmonary tumors from January 2015 through July 2026. Of these, 138 underwent MT and 670 mMITS, including 605 mVATS and 65 mRATS. PSM (1:2) was performed for MT versus mMITS (n = 126 vs. 252) and mVATS versus mRATS (n = 126 vs. 63). We assessed operative outcomes, postoperative complications, pain-related outcomes only for the mVATS-mRATS comparison, and margin and nodal outcomes. Blood loss was lower with mMITS than with MT (5 vs. 20 mL, p < 0.001), and chest tube duration was shorter (p = 0.002). Margin and nodal outcomes did not differ significantly between MT and mMITS. mRATS was associated with less blood loss than mVATS (3 vs. 5 mL, p = 0.006), a shorter duration of regular oral analgesic use (20 vs. 31 days, p = 0.007), and greater hilar and mediastinal lymph node yields (hilar, p = 0.037; mediastinal, p = 0.025). For complex segmentectomy, mMITS was associated with less blood loss and shorter chest tube duration than MT, without significant differences in margin and nodal outcomes. Within mMITS, mRATS was associated with shorter regular oral analgesic use and greater hilar and mediastinal lymph node yields than mVATS.
SN - 1863-2483
SN - 1863-2491
ER -