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P. Patel
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P2.02 - Poster Session/ Treatment of Localized Disease – NSCLC (ID 210)
- Event: WCLC 2015
- Type: Poster
- Track: Treatment of Localized Disease - NSCLC
- Presentations: 1
- Moderators:
- Coordinates: 9/08/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P2.02-021 - Robotic Pulmonary Resection for Lung Cancer: Analysis of the Learning Curve in a Novel Surgical Program (ID 1730)
09:30 - 09:30 | Author(s): P. Patel
- Abstract
Background:
We present the first Canadian series of robotic pulmonary resection for lung cancer, examining the effects of learning curves associated with new technology on perioperative outcomes.
Methods:
Prospective databases at two institutions were queried for patients who underwent robotic pulmonary resection for lung cancer between October 2011 and February 2015. Data was collected on demographics, comorbidities, perioperative variables and complications. Results are presented as median (range). The learning curve effect was evaluated in temporal tertiles, stratified by surgeon. Differences in perioperative outcomes were evaluated using the Mantel-Cox Log-Rank test.
Results:
Of 116 patients included, 48% were males and median age was 67 (28-88). The majority (88%, 102/116) underwent a robotic lobectomy, 9% (11/116) a segmentectomy, and 3% (3/116) a wedge resection. Five patients (4%) were converted to thoracotomy. Median operative time was 281 minutes (134-650) and length of stay was 4 days (1-19). Total operative time decreased significantly (p<0.01) over the learning curve; tertile 1 (326 min (290-362)), tertile 2 (275 min (261-289)) and tertile 3 (235 min (210-260)). Median time spent on the robotic console also decreased significantly (p<0.01) over tertiles- 195 (144-246), 148 (136-160), and 116 (100-132) minutes, respectively. Across tertiles, there were no differences in the median number of lymph node stations harvested (6, 5, 6; p=0.33), length of stay (4, 4, 4; p=0.25, or the rate of major complications (Clavien-Dindo Class >= III; 5, 1, 4, respectively; p=0.26). There were no mortalities.
Conclusion:
The early Canadian experience with robotic lung cancer resection demonstrates excellent results that are comparable to those of experienced centers in operative times, length of stay and conversion rates. Further improvement was demonstrated by the learning curve effect. A prospective study to examine the outcomes and cost of robotic pulmonary resection compared to video-assisted thoracoscopic surgery should be done in the context of the Canadian healthcare system.
