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<p>The relative benefits of Robotic-assisted thoracoscopic segmentectomy (RATS) versus video-assisted thoracoscopic segmentectomy (VATS) for early-stage NSCLC remain uncertain. This meta-analysis compared perioperative outcomes, lymph node assessment, and postoperative safety between the two approaches. PubMed, Cochrane Library, Embase, and Web of Science were searched from inception to April 2026. Comparative studies of RATS versus VATS segmentectomy for early-stage NSCLC were included. Outcomes were pooled as weighted mean differences or odds ratios with 95% confidence intervals. Random-effects models were used for substantial heterogeneity (I² &gt;50% or <i>P</i> &lt; 0.05); otherwise, fixed-effects models were applied. Leave-one-out sensitivity plots are provided in the supplementary materials. Nine retrospective comparative studies involving 19,805 patients were included. Robotic-assisted segmentectomy was associated with a greater number of lymph node stations examined (WMD = 1.16, 95% CI: 0.51, 1.81, <i>P</i> &lt; 0.001) and a shorter length of hospital stay (WMD = − 0.75, 95% CI: −1.36, − 0.15, <i>P</i> = 0.015). No significant differences were observed in operative time (WMD = 1.86, 95% CI: −8.80, 12.52, <i>P</i> = 0.732), duration of drainage (WMD = − 0.37, 95% CI: −0.79, 0.06, <i>P</i> = 0.090), overall complications (OR = 0.94, 95% CI: 0.67, 1.34, <i>P</i> = 0.745), air leak (OR = 1.02, 95% CI: 0.54, 1.91, <i>P</i> = 0.949), pneumonia (OR = 1.33, 95% CI: 0.89, 1.99, <i>P</i> = 0.170), or 30-day readmission (OR = 1.09, 95% CI: 0.94, 1.26, <i>P</i> = 0.257). Current retrospective evidence suggests that RATS may offer more examined lymph node stations and shorter hospital stay without increased morbidity, but these findings are limited by risk of bias and should not be interpreted as evidence of oncologic superiority.</p>

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Perioperative outcomes and nodal station assessment after robotic-assisted versus video-assisted thoracoscopic segmentectomy for early-stage NSCLC: a systematic review and meta-analysis

  • 期刊论文

  • 发表日期：

    2026年7月20日

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  • Yu-Huan Yu,
  • You-Peng Huang,
  • An-Bang Yu,
  • Yue Li,
  • Ping Sun,
  • Xia Liu,
  • Ya-Hua Tian

摘要

The relative benefits of Robotic-assisted thoracoscopic segmentectomy (RATS) versus video-assisted thoracoscopic segmentectomy (VATS) for early-stage NSCLC remain uncertain. This meta-analysis compared perioperative outcomes, lymph node assessment, and postoperative safety between the two approaches. PubMed, Cochrane Library, Embase, and Web of Science were searched from inception to April 2026. Comparative studies of RATS versus VATS segmentectomy for early-stage NSCLC were included. Outcomes were pooled as weighted mean differences or odds ratios with 95% confidence intervals. Random-effects models were used for substantial heterogeneity (I² >50% or P < 0.05); otherwise, fixed-effects models were applied. Leave-one-out sensitivity plots are provided in the supplementary materials. Nine retrospective comparative studies involving 19,805 patients were included. Robotic-assisted segmentectomy was associated with a greater number of lymph node stations examined (WMD = 1.16, 95% CI: 0.51, 1.81, P < 0.001) and a shorter length of hospital stay (WMD = − 0.75, 95% CI: −1.36, − 0.15, P = 0.015). No significant differences were observed in operative time (WMD = 1.86, 95% CI: −8.80, 12.52, P = 0.732), duration of drainage (WMD = − 0.37, 95% CI: −0.79, 0.06, P = 0.090), overall complications (OR = 0.94, 95% CI: 0.67, 1.34, P = 0.745), air leak (OR = 1.02, 95% CI: 0.54, 1.91, P = 0.949), pneumonia (OR = 1.33, 95% CI: 0.89, 1.99, P = 0.170), or 30-day readmission (OR = 1.09, 95% CI: 0.94, 1.26, P = 0.257). Current retrospective evidence suggests that RATS may offer more examined lymph node stations and shorter hospital stay without increased morbidity, but these findings are limited by risk of bias and should not be interpreted as evidence of oncologic superiority.