Background The present research is designed to evaluate the short-term outcome of robot-assisted thoracoscopic surgery (RATS) for the treatment of posterior mediastinal neurogenic tumors. Methods We retrospectively analyzed clinical data on 39 consecutive patients with mediastinal neurogenic tumors after RATS treatment completed by the same operator in the Department of Thoracic Surgery, Gansu Provincial People's Hospital from January 2016 to September 2022. There were 22 males and 17 females with a mean age of (35.1 ± 6.9) years in this analysis report. The tumors of the patients were localized and evaluated preoperatively using magnetic resonance imaging (MRI) or enhanced CT. Results All 39 patients successfully underwent the resection of posterior mediastinal neurogenic tumors under RATS, and no conversion to thoracotomy occurred during the operations. The average operative time was (62.1 ± 17.2) min, the average docking time was (10.1 ± 2.5) min, the average intraoperative bleeding was (32.8 ± 19.5) ml, the average 24-h postoperative chest drainage was (67.4 ± 27.9) ml, the average postoperative chest drainage time was (2.2 ± 1.3) days and the average post-operative hospital stay was (3.2 ± 1.3) days. Postoperative complications occurred in 3 patients, including 2 patients with transient Horner's syndrome after surgery and 1 patient with transient anhidrosis of the affected upper limb after surgery. Conclusion RATS for posterior mediastinal neurogenic tumors is safe, effective, feasible and bring the superiority of robotic surgical system into full play.

Background The purpose of this study was to compare the perioperative efficacy and safety of da Vinci robot-assisted thoracoscopic surgery (RATS) for treating anterior mediastinal tumors through the subxiphoid and lateral thoracic approaches under the anesthesia of nontracheal intubation (i.e., laryngeal mask airway). Methods We retrospectively analyzed the clinical data of 116 patients with anterior mediastinal tumors treated by RATS under laryngeal mask anesthesia completed by the same operator in the Department of Thoracic Surgery, Gansu Provincial People’s Hospital, from October 2016 to October 2022. There were a total of 52 patients including 24 males and 28 females, with an average age of 45.40±4.94 years, in the subxiphoid approach (subxiphoid group). On the other hand, there were a total of 64 patients including 34 males and 30 females, with a mean age of 46.86±5.46 years in the lateral thoracic approach (lateral thoracic group). Furthermore, we have detailedly compared and analyzed the operating time, intraoperative bleeding, and total postoperative drainage in the two groups. Results All patients in both groups successfully completed resection of the anterior mediastinal tumor without occurring perioperative death. Compared with the lateral thoracic group, the subxiphoid group has more advantages in terms of total postoperative drainage (P=0.035), postoperative drainage time (P=0.015), postoperative hospital stay (P=0.030), and visual analog scale (VAS) pain on postoperative days 2 (P=0.006) and 3 (P=0.002). However, the lateral thoracic group has more advantages in the aspect of docking time (P=0.020). There was no statistically significant difference between the two groups in terms of operative time (P=0.517), total operative time (P=0.187), postoperative day 1 VAS pain score (P=0.084), and postoperative complications (P=0.715). Conclusion The subxiphoid approach of RATS under laryngeal mask anesthesia is safe and feasible for resecting anterior mediastinal tumors. Compared with the lateral thoracic approach, the subxiphoid approach has advantages in terms of rapid postoperative recovery and postoperative patient pain, and patient acceptance is also higher and thus is worth promoting in hospitals where it is available.

Objective To assess the impact of da Vinci robot versus thoracoscopic surgery on body trauma and lymphocyte subsets in lung cancer patients. Methods Retrospective analysis of 352 patients with lung cancer treated by minimally invasive surgery completed by the same operator in the Department of Thoracic Surgery, Gansu Provincial People's Hospital from October 2019 to October 2022. The patients were divided into a robotic-assisted thoracic surgery(RATS) group (n = 159) and a video-assisted thoracoscopic surgery group(VATS) (n = 193) according to the surgical procedure. Propensity score matching analysis (PSM) was performed in both groups, and perioperative indicators were recorded. Levels of inflammatory markers (C-reactive protein, CRP; interleukin-6, IL-6) and lymphocyte subsets (CD3+, CD4+, CD8+, CD4+/CD8+) were measured 1 day before surgery, 1, 3 and 5 days after surgery, respectively. To compare the effects of the two surgical procedures on the trauma and lymphocyte subsets of the patient's organism. Results 138 patients in each group after PSM. The operative time, intraoperative bleeding, postoperative drainage time, and drainage flow were all lower in the RATS group than in the VATS group, with statistically significant differences (P < 0.05). The levels of CRP and IL-6 increased in both groups after surgery compared with those before surgery, and the increase was less in the RATS group than in the VATS group. Postoperative T-lymphocyte levels were lower in both groups compared with preoperative levels, and T-lymphocyte levels were significantly lower in the VATS group compared with the RATS group (P < 0.05). Conclusion Compared with thoracoscopic radical lung cancer surgery, robotic radical lung cancer surgery is clinically superior because it is less invasive, induces less inflammatory response in the body, has faster recovery, and has less suppressive effects on lymphocyte subpopulations.

BackgroundTo assess the impact of da Vinci robot versus thoracoscopic surgery on body trauma and lymphocyte subsets in lung cancer patients.MethodsRetrospective analysis of 352 patients with lung cancer treated by minimally invasive surgery completed by the same operator in the Department of Thoracic Surgery, Gansu Provincial People's Hospital from October 2019 to October 2022. According to the surgical procedure, the patients were divided into a robotic‐assisted thoracic surgery (RATS) group (n = 159) and a video‐assisted thoracoscopic surgery group (VATS) (n = 193), respectively. Propensity score matching (PSM) analysis was performed in both groups, and perioperative indicators were recorded. Levels of inflammatory markers (C‐reactive protein, CRP; interleukin‐6, IL‐6) and lymphocyte subsets (CD3+, CD4+, CD8+, and CD4+/CD8+) were measured 1 day before surgery and 1, 3, and 5 days after surgery, respectively. To compare the effects of the two surgical procedures on the trauma and lymphocyte subsets of the patient's organism.ResultsOne hundred and thirty‐eight patients in each group after PSM. Compared with the VATS group, the RATS group had shorter operative time (p < 0.001), less intraoperative bleeding (p < 0.001), less postoperative chest drainage (p = 0.029), shorter postoperative chest drainage time (p = 0.008), and shorter postoperative hospital stay (p = 0.005). The levels of CRP and IL‐6 increased in both groups after surgery compared with those before surgery, and the increase was less in the RATS group than that in the VATS group. Postoperative T‐lymphocyte levels were lower in both groups compared with preoperative levels, and T‐lymphocyte levels were significantly lower in the VATS group compared with the RATS group.ConclusionCompared with VATS for treating lung cancer, RATS has advantages in short‐term efficacy, and smaller surgical trauma to patients, which can reduce the body's inflammatory response. It also has less impact on T lymphocyte subpopulations, which can better protect patients’ immune function.