A Retrospective Examination Of The Effectiveness And Security Of Robot-less Invasive Surgery In Comparison To Traditional Thoracoscopic Surgery In The Treatment Of Lung Cancer After Neoadjuvant Immunotherapy Combined With Chemotherapy Was Conducted

Objective:Compare the efficacy and safety of robot assisted thoracoscopic surgery with traditional thoracoscopic surgery in the treatment of stage Ⅱ-Ⅲ non-small cell lung cancer patients after neoadjuvant immunotherapy combined with chemotherapy.Methods:Retrospective analysis was made on the clinical data of patients with non-small cell lung cancer who received neoadjuvant immune therapy combined with chemotherapy in the thoracic surgery of the First Affiliated Hospital of Nanchang University from January 2020 to February 2023.According to the surgical methods,the patients were divided into robot assisted thoracoscopy group(RATS)and traditional thoracoscopy group(VATS).Compare perioperative related data between two groups of patients.Results:A total of 124 cases were included in the RATS and VATS groups,including 102 males and 22 females,with an average age of(60.41 ± 8.79)years.There were no statistically significant differences in baseline indicators such as gender,age,body mass index,underlying disease,tumor size,resection site,and TNM staging between the two groups of enrolled patients(P>0.05).There was no significant difference between the two groups in terms of surgical time,intraoperative bleeding,thoracic drainage volume on the first day after surgery,and postoperative complications(chylothorax,postoperative bleeding),P<0.05.There were significant differences in the number and number of intraoperative lymph node dissection stations,intraoperative conversion to thoracotomy,postoperative hospital stay,postoperative thoracic drainage time,postoperative complications(air leakage,dry cough,and postoperative infection),and hospitalization costs between the two groups of surgeries.The number of intraoperative lymph node dissection stations in the RATS group[(7.2 ± 0.7)group vs(6.0 ± 1.2)group,P<0.05],and the number of intraoperative lymph node dissection stations[(19.5 ± 6.6)vs(14.2 ± 8.3),P<0.05]were better than those in the VATS group.Two groups of surgeries were compared in terms of intraoperative conversion to thoracotomy,postoperative hospital stay,postoperative drainage time of thoracic drainage tube,and postoperative complications(air leakage,dry cough,and postoperative infection).Among them,the RATS group was superior to the VATS group,with statistical significance(P<0.05).The hospitalization expenses of the RATS group were higher than those of the VATS group[(82553.2±13541.1)yuan vs(68622.6 ± 13107.5)yuan,P<0.05],with a statistically significant difference.Conclusion:Both VATS and RATS are safe and feasible for the treatment of stage Ⅱ-Ⅲnon-small cell lung cancer patients after neoadjuvant immunotherapy combined with chemotherapy;RATS is superior to the VATS group in terms of the number and number of lymph node dissection stations,conversion rate to thoracotomy,postoperative hospital stay,postoperative thoracic drainage time,and postoperative complications(air leakage,dry cough,and postoperative infection).VATS has lower hospitalization costs,and it is recommended to choose RATS as the preferred surgical method for such patients when not considering the hospitalization costs of patients.