Comparative study of pulmonary function retention after video-assisted thoracic surgery and robot-assisted thoracic surgery_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

SUI Tianyi , QIN Yi , SUN Xiao , WANG Yuanyong , LU Tong , XIE Boheng ,  JIAO Wenjie

Department of Thoracic Surgery, Affiliated Hospital of Qingdao University, Qingdao, 266071, Shandong, P.R.China;

Corresponding author：

JIAO Wenjie, Email: jiaowj@qduhospital.cn

Keywords：

Video-assisted thoracic surgery; robot-assisted thoracic surgery; segmentectomy; pulmonary function; non-small cell lung cancer; treatment

DOI：

10.7507/1007-4848.202001055

Video：

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Objective To investigate the changes in pulmonary function after video-assisted thoracic surgery (VATS) and robot-assisted thoracic surgery (RATS) segmentectomy.Methods A total of 59 patients (30 males and 29 females) who underwent segmentectomy in the Affiliated Hospital of Qingdao University from July to October 2017 were included. There were 33 patients (18 males and 15 females) in the VATS group and 26 patients (12 males and 14 females) in the RATS group. Lung function tests were performed before surgery, 1 month, 6 months, and 12 months after surgery. Intra- and inter-group comparisons of lung function retention values were performed between the two groups of patients to analyze differences in lung function retention after VATS and RATS segmentectomy.Results The forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) in the VATS group and the RATS group were significantly lower than those before surgery (P<0.05), and they increased significantly within 6 months after surgery (P<0.05). The recovery was not obvious after 6 months (P>0.05), and they were still lower than those before surgery. In addition, the retentions of FEV1 and FVC in the VATS group and the RATS group were similar in 1 month, 6 months, and 12 months after operation with no statistical difference(P>0.05). Conclusion Pulmonary function decreases significantly in 1 month after minimally invasive segmentectomy, and the recovery is obvious in 6 months after the operation, then the pulmonary function recovery gradually stabilizes 12 months after surgery. FEV1 of the patients in the two groups recovers to 93% and 94%, respectively. There is no statistical difference in pulmonary function retention after VATS and RATS segmentectomy.

Citation： SUI Tianyi, QIN Yi, SUN Xiao, WANG Yuanyong, LU Tong, XIE Boheng, JIAO Wenjie. Comparative study of pulmonary function retention after video-assisted thoracic surgery and robot-assisted thoracic surgery. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2020, 27(8): 886-892. doi: 10.7507/1007-4848.202001055 Copy

1.	Sekine Y, Ko E, Oishi H, et al. A simple and effective technique for identification of intersegmental planes by infrared thoracoscopy after transbronchial injection of indocyanine green. Thorac Cardiovasc Surg, 2012, 143(6): 1330-1335.
2.	Siegel R, DeSantis C, Jemal A. Colorectal cancer statistics, 2014. CA Cancer J Clin, 2014, 64(2): 104-117.
3.	Kanzaki M. Current status of robot-assisted thoracoscopic surgery for lung cancer. Surg Today, 2019, 49(10): 795-802.
4.	Nakamura H, Suda T, Ikeda N, et al. Initial results of robot-assisted thoracoscopic surgery in Japan. Gen Thorac Cardiovasc Surg, 2014, 62(12): 720-725.
5.	Mungo B, Hooker CM, Ho JS, et al. Robotic versus thoracoscopic resection for lung cancer: early results of a new robotic program. Laparoendosc Adv Surg Tech A, 2016, 26(4): 243-248.
6.	Novellis P, Bottoni E, Voulaz E, et al. Robotic surgery, video-assisted thoracic surgery, and open surgery for early stage lung cancer: comparison of costs and outcomes at a single institute. Thorac Dis, 2018, 10(2): 790-798.
7.	Gardner RM. Standardization of spirometry: a summary of recommendations from the American Thoracic Society: the 1987 update. Ann Intern Med, 1988, 108(2): 217-220.
8.	Ginsberg RJ, Rubinstein LV, Lung Cancer Study Group. Randomized trial of lobectomy versus limited resection for T1N0 non-small cell lung cancer. Ann Thorac Surg, 1995, 60(3): 615-623.
9.	Koike T, Koike T, Sato S, et al. Lobectomy and limited resection in small-sized peripheral non-small cell lung cancer. Thorac Dis, 2016, 8(11): 3265-3274.
10.	Keenan RJ, Landreneau RJ, Maley Jr RH, et al. Segmental resection spares pulmonary function in patients with stage Ⅰ lung cancer. Ann Thorac Surg, 2004, 78(1): 228-233.
11.	Moon MH, Moon YK, Moon SW. Segmentectomy versus lobectomy in early non-small cell lung cancer of 2 cm or less in size: A population-based study. Respirology, 2018, 23(7): 695-703.
12.	Tamari S, Nishikawa S, Aizawa R, et al. Clinical characteristics after surgery of non-small cell lung cancer which measures 20 mm or less in diameter. Kyobu Geka, 2012, 65(1): 29-34.
13.	Song CY, Sakai T, Kimura D, et al. Comparison of perioperative and oncological outcomes between video-assisted segmentectomy and lobectomy for patients with clinical stage ⅠA non-small cell lung cancer: a propensity score matching study. Thorac Dis, 2018, 10(8): 4891-4901.
14.	Zhang YJ, Gao YS. Effects of VATS lobectomy, VATS anatomic segmentectomy, and open thoracotomy on pulmonary function of patients with non-small cell lung cancer. Zhongguo Fei Ai Za Zhi, 2016, 19(10): 700-704.
15.	Saito H, Nakagawa T, Ito M, et al. Pulmonary function after lobectomy versus segmentectomy in patients with stage Ⅰ non-small cell lung cancer. World J Surg, 2014, 38(8): 2025-2031.
16.	Lim E, Baldwin D, Beckles M, et al. Guidelines on the radical management of patients with lung cancer. Thorax, 2010, 65(Suppl 3): iii1-iii27.
17.	Suzuki H, Morimoto J, Mizobuchi T, et al. Does segmentectomy really preserve the pulmonary function better than lobectomy for patients with early-stage lung cancer? Surg Today, 2017, 47(4): 463-469.
18.	Kim SJ, Lee YJ, Park JS, et al. Changes in pulmonary function in lung cancer patients after video-assisted thoracic surgery. Ann Thorac Surg, 2015, 99(1): 210-217.
19.	Takizawa T, Haga M, Yagi N, et al. Pulmonary function after segmentectomy for small peripheral carcinoma of the lung. J Thorac Cardiovasc Surg, 1999, 118(3): 536-541.
20.	Gu Z, Wang H, Mao T, et al. Pulmonary function changes after different extent of pulmonary resection under video-assisted thoracic surgery. Thorac Dis, 2018, 10(4): 2331-2337.
21.	Nomori H, Cong Y, Sugimura H. Systemic and regional pulmonary function after segmentectomy. Thorac Cardiovasc Surg, 2016, 152(3): 747-753.
22.	Takahashi Y, Izumi Y, Kohno M, et al. Thyroid transcription factor-1 influences the early phase of compensatory lung growth in adult mice. Am J Respir Crit Care Med, 2010, 181(12): 1397-1406.
23.	Jang HJ, Lee HS, Park SY, et al. Comparison of the early robot-assisted lobectomy experience to video-assisted thoracic surgery lobectomy for lung cancer: a single-institution case series matching study. Innovations (Phila), 2011, 6(5): 305-310.
24.	Yang S, Guo W, Chen X, et al. Early outcomes of robotic versus uniportal video-assisted thoracic surgery for lung cancer: a propensity score-matched study. Eur J Cardiothorac Surg, 2018, 53(2): 348-352.
25.	Nagamatsu Y, Maeshiro K, Kimura NY, et al. Long-term recovery of exercise capacity and pulmonary function after lobectomy. J Thorac Cardiovasc Surg, 2007, 134(5): 1273-1278.
26.	Miyoshi S, Yoshimatsu T, Hirai T, et al. Exercise capacity of thoracotomy patients in the early postoperative period. Chest, 2000, 118(2): 384-390.

1. Sekine Y, Ko E, Oishi H, et al. A simple and effective technique for identification of intersegmental planes by infrared thoracoscopy after transbronchial injection of indocyanine green. Thorac Cardiovasc Surg, 2012, 143(6): 1330-1335.
2. Siegel R, DeSantis C, Jemal A. Colorectal cancer statistics, 2014. CA Cancer J Clin, 2014, 64(2): 104-117.
3. Kanzaki M. Current status of robot-assisted thoracoscopic surgery for lung cancer. Surg Today, 2019, 49(10): 795-802.
4. Nakamura H, Suda T, Ikeda N, et al. Initial results of robot-assisted thoracoscopic surgery in Japan. Gen Thorac Cardiovasc Surg, 2014, 62(12): 720-725.
5. Mungo B, Hooker CM, Ho JS, et al. Robotic versus thoracoscopic resection for lung cancer: early results of a new robotic program. Laparoendosc Adv Surg Tech A, 2016, 26(4): 243-248.
6. Novellis P, Bottoni E, Voulaz E, et al. Robotic surgery, video-assisted thoracic surgery, and open surgery for early stage lung cancer: comparison of costs and outcomes at a single institute. Thorac Dis, 2018, 10(2): 790-798.
7. Gardner RM. Standardization of spirometry: a summary of recommendations from the American Thoracic Society: the 1987 update. Ann Intern Med, 1988, 108(2): 217-220.
8. Ginsberg RJ, Rubinstein LV, Lung Cancer Study Group. Randomized trial of lobectomy versus limited resection for T1N0 non-small cell lung cancer. Ann Thorac Surg, 1995, 60(3): 615-623.
9. Koike T, Koike T, Sato S, et al. Lobectomy and limited resection in small-sized peripheral non-small cell lung cancer. Thorac Dis, 2016, 8(11): 3265-3274.
10. Keenan RJ, Landreneau RJ, Maley Jr RH, et al. Segmental resection spares pulmonary function in patients with stage Ⅰ lung cancer. Ann Thorac Surg, 2004, 78(1): 228-233.
11. Moon MH, Moon YK, Moon SW. Segmentectomy versus lobectomy in early non-small cell lung cancer of 2 cm or less in size: A population-based study. Respirology, 2018, 23(7): 695-703.
12. Tamari S, Nishikawa S, Aizawa R, et al. Clinical characteristics after surgery of non-small cell lung cancer which measures 20 mm or less in diameter. Kyobu Geka, 2012, 65(1): 29-34.
13. Song CY, Sakai T, Kimura D, et al. Comparison of perioperative and oncological outcomes between video-assisted segmentectomy and lobectomy for patients with clinical stage ⅠA non-small cell lung cancer: a propensity score matching study. Thorac Dis, 2018, 10(8): 4891-4901.
14. Zhang YJ, Gao YS. Effects of VATS lobectomy, VATS anatomic segmentectomy, and open thoracotomy on pulmonary function of patients with non-small cell lung cancer. Zhongguo Fei Ai Za Zhi, 2016, 19(10): 700-704.
15. Saito H, Nakagawa T, Ito M, et al. Pulmonary function after lobectomy versus segmentectomy in patients with stage Ⅰ non-small cell lung cancer. World J Surg, 2014, 38(8): 2025-2031.
16. Lim E, Baldwin D, Beckles M, et al. Guidelines on the radical management of patients with lung cancer. Thorax, 2010, 65(Suppl 3): iii1-iii27.
17. Suzuki H, Morimoto J, Mizobuchi T, et al. Does segmentectomy really preserve the pulmonary function better than lobectomy for patients with early-stage lung cancer? Surg Today, 2017, 47(4): 463-469.
18. Kim SJ, Lee YJ, Park JS, et al. Changes in pulmonary function in lung cancer patients after video-assisted thoracic surgery. Ann Thorac Surg, 2015, 99(1): 210-217.
19. Takizawa T, Haga M, Yagi N, et al. Pulmonary function after segmentectomy for small peripheral carcinoma of the lung. J Thorac Cardiovasc Surg, 1999, 118(3): 536-541.
20. Gu Z, Wang H, Mao T, et al. Pulmonary function changes after different extent of pulmonary resection under video-assisted thoracic surgery. Thorac Dis, 2018, 10(4): 2331-2337.
21. Nomori H, Cong Y, Sugimura H. Systemic and regional pulmonary function after segmentectomy. Thorac Cardiovasc Surg, 2016, 152(3): 747-753.
22. Takahashi Y, Izumi Y, Kohno M, et al. Thyroid transcription factor-1 influences the early phase of compensatory lung growth in adult mice. Am J Respir Crit Care Med, 2010, 181(12): 1397-1406.
23. Jang HJ, Lee HS, Park SY, et al. Comparison of the early robot-assisted lobectomy experience to video-assisted thoracic surgery lobectomy for lung cancer: a single-institution case series matching study. Innovations (Phila), 2011, 6(5): 305-310.
24. Yang S, Guo W, Chen X, et al. Early outcomes of robotic versus uniportal video-assisted thoracic surgery for lung cancer: a propensity score-matched study. Eur J Cardiothorac Surg, 2018, 53(2): 348-352.
25. Nagamatsu Y, Maeshiro K, Kimura NY, et al. Long-term recovery of exercise capacity and pulmonary function after lobectomy. J Thorac Cardiovasc Surg, 2007, 134(5): 1273-1278.
26. Miyoshi S, Yoshimatsu T, Hirai T, et al. Exercise capacity of thoracotomy patients in the early postoperative period. Chest, 2000, 118(2): 384-390.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Comparative study of pulmonary function retention after video-assisted thoracic surgery and robot-assisted thoracic surgery

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