Roboterassistierte anatomische Lungenresektion: Technik, Evidenz und Datenlage

Zusammenfassung

Die roboterassistierte Thoraxchirurgie (RATS) hat dank verbesserter Visualisierung und optimierter Instrumente (sog. Endowrist-Funktion) einen enormen technischen Fortschritt in der thoraxchirurgischen Versorgung von Patienten gebracht. Auch die Durchführung komplexer thorakaler oder mediastinaler chirurgischer Eingriffe, bspw. mit einer intrathorakalen Naht, sind nunmehr möglich. Infolgedessen wird diese Technologie zunehmend übernommen und in der therapeutischen Anwendung implementiert. Während die Zahl der konventionellen Thorakotomien bei Lungenkrebs weltweit zurückgeht, ist ein kontinuierlicher Anstieg der minimalinvasiven Resektionen beim Bronchialkarzinom zu beobachten. Ziel dieser Arbeit ist es, einen aktuellen Überblick über roboterassistierte Operationen beim Lungenkarzinom zu geben.

Abstract

Thanks to improved visualisation and instruments with an endowrist function, robot-assisted thoracic surgery has led to technical progress in thoracic surgery. This makes it easier to carry out complex thoracic surgical interventions, e.g. with an intrathoracic suture. As a result, this technology is increasingly being adopted and implemented in therapeutic use. Worldwide, the number of thoracotomies for lung cancer has decreased, while the number of minimally invasive surgical thoracic resections has increased. The aim of this work is to give an up-to-date overview of robotic operations on bronchial carcinoma.

Schlüsselwörter

RATS - Lobektomie - Segmentektomie - Roboterchirurgie - Lungenkarzinom

Keywords

RATS - lobectomy - segmentectomy - robotic surgery - lung cancer

Publikationsverlauf

Eingereicht: 20. September 2022

Angenommen nach Revision: 02. Dezember 2022

Artikel online veröffentlicht:
30. Januar 2023

• Literatur

• 1 Rocco G, Internullo E, Cassivi SD. et al. The variability of practice in minimally invasive thoracic surgery for pulmonary resections. Thorac Surg Clin 2008; 18: 235-247 DOI: 10.1016/j.thorsurg.2008.06.002. (PMID: 18831498)
• 2 Johnson J, Kirby CK, Blakemore WS. Should we insist on radical pneumonectomy as routine procedure in the treatment of carcinoma of the lung?. J Thorac Surg 1958; 36: 309-315 (PMID: 13576560)
• 3 Dylewski MR, Ohaeto AC, Pereira JF. Pulmonary resection using a total endoscopic robotic video-assisted approach. Semin Thorac Cardiovasc Surg 2011; 23: 36-42 DOI: 10.1053/j.semtcvs.2011.01.005. (PMID: 21807297)
• 4 Veronesi G, Galetta D, Maisonneuve P. et al. Four-arm robotic lobectomy for the treatment of early-stage lung cancer. J Thorac Cardiovasc Surg 2010; 140: 19-25 DOI: 10.1016/j.jtcvs.2009.10.025. (PMID: 20038475)
• 5 Cerfolio RJ, Bryant AS. Robotic-assisted pulmonary resection – right upper lobectomy. Ann Cardiothorac Surg 2012; 1: 77-85 DOI: 10.3978/j.issn.2225-319X.2012.04.12. (PMID: 23977471)
• 6 Cerfolio RJ. Robotic sleeve lobectomy: technical details and early results. J Thorac Dis 2016; 8 (Suppl. 02) S223-S226 DOI: 10.3978/j.issn.2072-1439.2016.01.70. (PMID: 26981274)
• 7 Gómez-Caro A, Calvo MJ, Lanzas JT. et al. The approach of fused fissures with fissureless technique decreases the incidence of persistent air leak after lobectomy. Eur J Cardiothorac Surg 2007; 31: 203-208 DOI: 10.1016/j.ejcts.2006.11.030.
• 8 Yang CF, D’Amico TA. Thoracoscopic segmentectomy for lung cancer. Ann Thorac Surg 2012; 94: 668-681 DOI: 10.1016/j.athoracsur.2012.03.080. (PMID: 22748648)
• 9 Geraci TC, Ferrari-Light D, Kent A. et al. Technique, Outcomes With Navigational Bronchoscopy Using Indocyanine Green for Robotic Segmentectomy. Ann Thorac Surg 2019; 108: 363-369 DOI: 10.1016/j.athoracsur.2019.03.032. (PMID: 30980818)
• 10 Oizumi H, Kanauchi N, Kato H. et al. Anatomic thoracoscopic pulmonary segmentectomy under 3-dimensional multidetector computed tomography simulation: a report of 52 consecutive cases. J Thorac Cardiovasc Surg 2011; 141: 678-682 DOI: 10.1016/j.jtcvs.2010.08.027. (PMID: 20884021)
• 11 Abbas AE. Surgical Management of Lung Cancer: History, Evolution, and Modern Advances. Curr Oncol Rep 2018; 20: 98 DOI: 10.1007/s11912-018-0741-7. (PMID: 30421260)
• 12 Jensik RJ, Faber LP, Milloy FJ. et al. Segmental resection for lung cancer. A fifteen-year experience. J Thorac Cardiovasc Surg 1973; 66: 563-572 (PMID: 4356889)
• 13 Cerfolio RJ, Watson C, Minnich DJ. et al. One Hundred Planned Robotic Segmentectomies: Early Results, Technical Details, and Preferred Port Placement. Ann Thorac Surg 2016; 101: 1089-1095 DOI: 10.1016/j.athoracsur.2015.08.092. (PMID: 26846343)
• 14 Ginsberg RJ, Rubinstein LV. Randomized trial of lobectomy versus limited resection for T1 N0 non-small cell lung cancer. Lung Cancer Study Group. Ann Thorac Surg 1995; 60: 615-622 DOI: 10.1016/0003-4975(95)00537-u. (PMID: 7677489)
• 15 Nakamura K, Saji H, Nakajima R. et al. A phase III randomized trial of lobectomy versus limited resection for small-sized peripheral non-small cell lung cancer (JCOG0802/WJOG4607L). Jpn J Clin Oncol 2010; 40: 271-274 DOI: 10.1093/jjco/hyp156. (PMID: 19933688)
• 16 Nomori H, Mori T, Ikeda K. et al. Segmentectomy for selected cT1N0M0 non-small cell lung cancer: a prospective study at a single institute. J Thorac Cardiovasc Surg 2012; 144: 87-93 DOI: 10.1016/j.jtcvs.2012.03.034. (PMID: 22502969)
• 17 Tsutani Y, Miyata Y, Nakayama H. et al. Oncologic outcomes of segmentectomy compared with lobectomy for clinical stage IA lung adenocarcinoma: propensity score-matched analysis in a multicenter study. J Thorac Cardiovasc Surg 2013; 146: 358-364 DOI: 10.1016/j.jtcvs.2013.02.008. (PMID: 23477694)
• 18 Ha KJ, Yun JK, Lee GD. et al. Surgical Outcomes of Radiographically Noninvasive Lung Adenocarcinoma according to Surgical Strategy: Wedge Resection, Segmentectomy, and Lobectomy. Korean J Thorac Cardiovasc Surg 2018; 51: 376-383 DOI: 10.5090/kjtcs.2018.51.6.376. (PMID: 30588445)
• 19 Bédat B, Abdelnour-Berchtold E, Perneger T. et al. Comparison of postoperative complications between segmentectomy and lobectomy by video-assisted thoracic surgery: a multicenter study. J Cardiothorac Surg 2019; 14: 189 DOI: 10.1186/s13019-019-1021-9. (PMID: 31699121)
• 20 Cao J, Yuan P, Wang Y. et al. Survival Rates After Lobectomy, Segmentectomy, and Wedge Resection for Non-Small Cell Lung Cancer. Ann Thorac Surg 2018; 105: 1483-1491 DOI: 10.1016/j.athoracsur.2018.01.032. (PMID: 29462591)
• 21 Altorki NK, Wang X, Wigle D. et al. Perioperative mortality and morbidity after sublobar versus lobar resection for early-stage non-small-cell lung cancer: post-hoc analysis of an international, randomised, phase 3 trial (CALGB/Alliance 140503). Lancet Respir Med 2018; 6: 915-924 DOI: 10.1016/S2213-2600(18)30411-9. (PMID: 30442588)
• 22 Saji H, Okada M, Tsuboi M. et al. Segmentectomy versus lobectomy in small-sized peripheral non-small-cell lung cancer (JCOG0802/WJOG4607L): a multicentre, open-label, phase 3, randomised, controlled, non-inferiority trial. Lancet 2022; 399: 1607-1617 DOI: 10.1016/S0140-6736(21)02333-3. (PMID: 35461558)
• 23 Cao C, Louie BE, Melfi F. et al. Impact of pulmonary function on pulmonary complications after robotic-assisted thoracoscopic lobectomy. Eur J Cardiothorac Surg 2020; 57: 338-342 DOI: 10.1093/ejcts/ezz205. (PMID: 31332434)
• 24 Macke RA, Schuchert MJ, Odell DD. et al. Parenchymal preserving anatomic resections result in less pulmonary function loss in patients with Stage I non-small cell lung cancer. J Cardiothorac Surg 2015; 10: 49 DOI: 10.1186/s13019-015-0253-6. (PMID: 25888465)
• 25 Charloux A, Quoix E. Lung segmentectomy: does it offer a real functional benefit over lobectomy?. Eur Respir Rev 2017; 26: 170079 DOI: 10.1183/16000617.0079-2017. (PMID: 29070582)
• 26 Nomori H, Shiraishi A, Cong Y. et al. Differences in postoperative changes in pulmonary functions following segmentectomy compared with lobectomy. Eur J Cardiothorac Surg 2018; 53: 640-647 DOI: 10.1093/ejcts/ezx357. (PMID: 29048464)
• 27 Pardolesi A, Veronesi G. Robot-assisted lung anatomic segmentectomy: technical aspects. Thorac Surg Clin 2014; 24: 163-168 DOI: 10.1016/j.thorsurg.2014.02.008. (PMID: 24780420)
• 28 Kim DH, Na KJ, Park IK. et al. Long-Term Outcomes in Stage I Lung Cancer After Segmentectomy with a Close Resection Margin. J Chest Surg 2021; 54: 361-368 DOI: 10.5090/jcs.21.045. (PMID: 34611084)
• 29 Toker A, Ozyurtkan MO, Kaba E. et al. Robotic anatomic lung resections: the initial experience and description of learning in 102 cases. Surg Endosc 2016; 30: 676-683 DOI: 10.1007/s00464-015-4259-x. (PMID: 26091996)
• 30 Cheufou DH, Mardanzai K, Ploenes T. et al. Effectiveness of Robotic Lobectomy-Outcome and Learning Curve in a High Volume Center. Thorac Cardiovasc Surg 2019; 67: 573-577 DOI: 10.1055/s-0038-1639477. (PMID: 29625502)
• 31 Meyer M, Gharagozloo F, Tempesta B. et al. The learning curve of robotic lobectomy. Int J Med Robot 2012; 8: 448-452 DOI: 10.1002/rcs.1455. (PMID: 22991294)
• 32 Weksler B. Defining the learning curve for minimally invasive segmentectomy. J Thorac Cardiovasc Surg 2018; 156: 2004-2005 DOI: 10.1016/j.jtcvs.2018.06.065. (PMID: 30126658)
• 33 Veronesi G, Maisonneuve P, Rampinelli C. et al. Computed tomography screening for lung cancer: results of ten years of annual screening and validation of cosmos prediction model. Lung Cancer 2013; 82: 426-430 DOI: 10.1016/j.lungcan.2013.08.026. (PMID: 24099665)
• 34 Servais EL, Miller DL, Thibault DP. et al. Conversion to Thoracotomy During Thoracoscopic vs Robotic Lobectomy: Predictors and Outcomes. Ann Thorac Surg 2022; 114: 409-417 DOI: 10.1016/j.athoracsur.2021.10.067. (PMID: 34921815)
• 35 Cao C, Cerfolio RJ, Louie BE. et al. Incidence, Management, and Outcomes of Intraoperative Catastrophes During Robotic Pulmonary Resection. Ann Thorac Surg 2019; 108: 1498-1504 DOI: 10.1016/j.athoracsur.2019.05.020. (PMID: 31255610)
• 36 Pardolesi A, Park B, Petrella F. et al. Robotic anatomic segmentectomy of the lung: technical aspects and initial results. Ann Thorac Surg 2012; 94: 929-934 DOI: 10.1016/j.athoracsur.2012.04.086. (PMID: 22748642)