Use of Robotics in Surgical Treatment of Non-small Cell Lung Cancer
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Lung Cancer (HA Wakelee and TA Leal, Section Editors)
Use of Robotics in Surgical Treatment of Non-small Cell Lung Cancer Lawek Berzenji, MD Krishan Yogeswaran, MD Paul Van Schil, MD, PhD Patrick Lauwers, MD Jeroen M. H. Hendriks, MD, PhD, FEBTS* Address * Department of Thoracic and Vascular Surgery, University Hospital of Antwerp, Antwerp University, Level 2, Route 146, Wilrijkstraat 10, B-2650, Edegem (Antwerp), Belgium Email: [email protected]
* Springer Science+Business Media, LLC, part of Springer Nature 2020
This article is part of the Topical Collection on Lung Cancer Keywords Non-small cell lung cancer I Minimally invasive surgery I da Vinci I Robotic-assisted videothoracoscopic surgery (R-VATS) I Lobectomy I Segmentectomy
Opinion statement Robotic-assisted videothoracoscopic surgery (R-VATS) has become increasingly popular and widely used since its introduction and is nowadays considered a standard treatment approach in many centres for the treatment of non-small cell lung cancer. R-VATS was initially developed to overcome the drawbacks of VATS by offering surgeons more flexibility and three-dimensional optics during thoracoscopic surgery. The effectiveness of R-VATS lobectomy regarding oncological outcomes, morbidity, mortality, and postoperative quality of life (QoL) has been shown in an increasing number of studies. More recently, these results have also been corroborated for sublobar resections, more specifically for segmentectomy. However, no well-powered, multicentre randomized trials have been performed to demonstrate the superiority of R-VATS compared with opensurgery or conventional types of VATS (total VATS, uniportal VATS, etc.). The majority of the evidence currently available is based on non-randomized studies, and many studies report conflicting results when comparing R-VATS and conventional VATS. Moreover, there is a lack of data regarding the cost and the cost-efficiency of robotic surgery compared with VATS and open surgery. Current evidence suggests that R-VATS costs are higher than VATS and that a deficit can only be prevented when up to 150–300 thoracic surgery procedures are performed annually. Finally, robotic-assisted laparoscopic surgery showed better ergonomics and reduced musculoskeletal disorders compared with non-robotic laparoscopic surgery.
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Curr. Treat. Options in Oncol.
(2020) 21:80
Introduction Lung cancer is the most common malignancy and one of the leading causes of cancer deaths worldwide [1]. Although worldwide rates of lung cancer vary, an overall increase in new cases of non-small cell lung cancer is seen, mainly due to rising incidences in developing countries [2]. In 2012, estimates have shown a total of 1.8 million new lung cancer diagnoses, comprising approximately 13% of all new cancer diagnoses. Furthermore, the 5-year survival rate of lung cancer (17.8%) remains significantly lower than any of the other leading cancers [1]. To battle these odds, a large number of first world countries have implemented tobacco control policies over t
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