A retrospective comparative cohort study on the efficacy and safety of bi-port robotic-assisted lobectomy and multi-port robotic-assisted lobectomy

Background: The pursuit of less surgical incisions brings better postoperative experience of patients and earns extensive popularity recently. As the update to the da Vinci robotic surgical system has reduced the size of the robotic arm, a new surgical method with fewer ports has become feasible. We performed 20 cases of robotic surgery with only 2 ports and compared the efficacy and safety between bi-port robotic-assisted lobectomy and multi-port robotic-assisted lobectomy. Methods: To compare the efficacy and safety of the different surgery strategies, we retrospectively reviewed 20 cases of bi-port robotic-assisted thoracic surgery ( RATS) and 40 cases of multi-port RATS which were performed at the Shanghai Chest Hospital Between February 2021 and May 2021. The baseline characteristics and their perioperative data were collected and analyzed. Chest tube drainage, chest tube removal time, lymphadenectomy outcomes, operation duration were collected to compare the efficacy of the two groups and blood loss, perioperative complications were recorded to value the safety. Results: A total of 60 surgeries in the 2 groups were successfully completed. The baseline characteristics in terms of sex, age, health statues were comparable (P=0.05). The maximum diameter of the tumor in the bi-port surgery group was 0.5-3.6 cm (2.0 +/- 1.0) vs. 0.5-4.0 cm (1.9 +/- 0.9) cm in the control group. No significant difference was discovered in terms of tumor location, tumor maximum diameter, tumor histology. The intraoperative blood loss was 60.0 +/- 20.5 mL and the average operation time was 95.6 +/- 21.4 min in the bi-port surgery group compared to 65.0 +/- 30.4 mL and 101.4 +/- 25.0 min in the control group. An average of 6.0 +/- 1.4 lymph nodes were collected in the bi-port surgery group with a mean diameter of 1.2 +/- 0.4 cm, and in the control group, an average of 6.1 +/- 1.6 lymph nodes were collected with a mean diameter was 1.2 +/- 0.5 cm. The average time of chest drainage was 4.3 +/- 1 vs. 5.1 +/- 1.3 days in the bi-port surgery group and control group. No statistical significance was found between the two groups (P>0.05). Conclusions: Compared to multi-port RATS, Bi-port robotic-assisted lobectomy was safe and showed promising efficacy in patients with early staged operable lung cancer.