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<p>The purpose of this study was to explore the clinical outcomes and safety of robot-assisted thoracoscopic surgery (RATS) for non-small cell lung cancer (NSCLC) patients following neoadjuvant treatment. The relevant literature up to June 3, 2024, was searched in PubMed, Embase, Cochrane Library, and Web of Science. The quality of the literature was evaluated using the Newcastle–Ottawa Scale. The I<sup>2</sup> statistic was employed to evaluate the consistency of the results. In two-arm trials, the pooled effect sizes were expressed as weighted mean difference (WMD) [95% confidence interval (CI)] or relative risk (RR) (95% CI), while in single-arm studies, the effect sizes were uniformly reported as effect size (ES) (95% CI). A total of 6 studies with 539 patients were included. The meta-analysis results indicated that compared to video-assisted thoracic surgery (VATS), RATS could remove a greater number of lymph nodes (WMD: 4.06, 95% CI 0.91, 7.21), harvested more lymph node (ES: 18.05, 95% CI 13.94, 22.17), and reduce the number of days of chest tube drainage (WMD: −&#xa0;1.12, 95% CI −&#xa0;1.64, −&#xa0;0.59). RATS appeared to be more likely to cause complications including pneumonia (RR: 3.31, 95% CI 1.12, 9.76), and thoracic VATS (RR (95% CI): 1.20 (0.56, 2.56). There were no statistically significant differences between the RATS and VATS groups in operative time, volume of drainage, total hospital stay, estimated blood loss, survival rate, total complications, complications of chronic air leakage, complications of pulmonary embolism, complications of anemia, blood transfusion rate, and the probability of switch to open surgery (all <i>P</i> &gt; 0.05). For patients with NSCLC who underwent neoadjuvant therapy, compared to VATS, receiving RATS may offer relatively better outcomes in reducing the number of days of chest tube drainage and the resection of a greater number of lymph nodes. While RATS may increase the risk of developing pneumonia. This study suggests that RATS may be a novel surgical approach for clinicians treating patients with NSCLC who underwent neoadjuvant therapy in the future, but there is still a need to carefully devise surgical or treatment plans to prevent the occurrence of related complications and may have higher cost and potential longer operative times.</p>

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Clinical efficacy and safety of robotic-assisted thoracic surgery after neoadjuvant therapy in non-small cell lung cancer: a systematic review and meta-analysis

  • 期刊论文

  • 发表日期：

    2026年2月23日

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  • Guanbiao Liang,
  • Huajian Peng,
  • Yongpeng Li

摘要

The purpose of this study was to explore the clinical outcomes and safety of robot-assisted thoracoscopic surgery (RATS) for non-small cell lung cancer (NSCLC) patients following neoadjuvant treatment. The relevant literature up to June 3, 2024, was searched in PubMed, Embase, Cochrane Library, and Web of Science. The quality of the literature was evaluated using the Newcastle–Ottawa Scale. The I2 statistic was employed to evaluate the consistency of the results. In two-arm trials, the pooled effect sizes were expressed as weighted mean difference (WMD) [95% confidence interval (CI)] or relative risk (RR) (95% CI), while in single-arm studies, the effect sizes were uniformly reported as effect size (ES) (95% CI). A total of 6 studies with 539 patients were included. The meta-analysis results indicated that compared to video-assisted thoracic surgery (VATS), RATS could remove a greater number of lymph nodes (WMD: 4.06, 95% CI 0.91, 7.21), harvested more lymph node (ES: 18.05, 95% CI 13.94, 22.17), and reduce the number of days of chest tube drainage (WMD: − 1.12, 95% CI − 1.64, − 0.59). RATS appeared to be more likely to cause complications including pneumonia (RR: 3.31, 95% CI 1.12, 9.76), and thoracic VATS (RR (95% CI): 1.20 (0.56, 2.56). There were no statistically significant differences between the RATS and VATS groups in operative time, volume of drainage, total hospital stay, estimated blood loss, survival rate, total complications, complications of chronic air leakage, complications of pulmonary embolism, complications of anemia, blood transfusion rate, and the probability of switch to open surgery (all P > 0.05). For patients with NSCLC who underwent neoadjuvant therapy, compared to VATS, receiving RATS may offer relatively better outcomes in reducing the number of days of chest tube drainage and the resection of a greater number of lymph nodes. While RATS may increase the risk of developing pneumonia. This study suggests that RATS may be a novel surgical approach for clinicians treating patients with NSCLC who underwent neoadjuvant therapy in the future, but there is still a need to carefully devise surgical or treatment plans to prevent the occurrence of related complications and may have higher cost and potential longer operative times.