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<p>The purpose of this meta-analysis was to compare the results of studies adjusted by propensity score to evaluate surgical quality and perioperative results between robotic-assisted thoracoscopic surgery (RATS) and video-assisted thoracoscopic surgery (VATS) in patients undergoing lobectomy due to non-small cell lung cancer (NSCLC). We searched different databases such as Embase, Pub Med, Cochrane library to obtain different related literatures that are retrievable until November 2025. We relied on Review Manager Computer Software so that we could compare the varying parameters. The trial is registered with PROSPERO (CRD420251229171). Seven eligible articles were selected, including four prospective trials and three retrospective studies, involving a total 829 patients, were included. The meta-analysis results suggested that RATS may present potential advantages over VATS regarding drained fluid quantity (MD − 29.83; 95% CI: −50.42 to − 9.23; <i>P</i> = 0.005), duration of hospital stay (MD − 0.14; 95% CI: −0.20 to − 0.07; <i>P</i> = 0.0001), lymph node dissection extent (MD 0.42; 95% CI: 0.18 to 0.66; <i>P</i> = 0.0005), and lower conversion to thoracotomy rates, which was achieved by the RATS approach (OR 0.18; 95% CI: 0.05 to 0.69; <i>P</i> = 0.01). However, the results failed to show any difference between the two systems regarding operation time, chest drainage duration, intraoperative bleeding, rates of complications, or air leakage rates. This meta-analysis and systematic review based on propensity score matching further enriches the existing evidence on RATS versus VATS for NSCLC. The findings show that RATS may hold certain advantages in some perioperative outcomes and surgical safety indicators. However, due to the high heterogeneity observed in some outcomes, clinical decision-making should involve a comprehensive evaluation based on the actual resource allocation of the hospital, the surgeon’s proficiency, cost-effectiveness, and individual patient factors, rather than relying solely on presumed technical superiority. Confirmation of this data is required by well-designed prospective, multicenter, randomized studies involving a greater number of patients, as well as longer-term follow-up.</p>

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Robot-assisted versus video-assisted surgery for early functional recovery in patients with non-small-cell lung cancer: a systematic review and meta-analysis of propensity score-based matching studies

  • 期刊论文

  • 发表日期：

    2026年3月2日

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  • Li-Jing Liang,
  • Guo-Yan Qi,
  • Zu-Lin Pan

摘要

The purpose of this meta-analysis was to compare the results of studies adjusted by propensity score to evaluate surgical quality and perioperative results between robotic-assisted thoracoscopic surgery (RATS) and video-assisted thoracoscopic surgery (VATS) in patients undergoing lobectomy due to non-small cell lung cancer (NSCLC). We searched different databases such as Embase, Pub Med, Cochrane library to obtain different related literatures that are retrievable until November 2025. We relied on Review Manager Computer Software so that we could compare the varying parameters. The trial is registered with PROSPERO (CRD420251229171). Seven eligible articles were selected, including four prospective trials and three retrospective studies, involving a total 829 patients, were included. The meta-analysis results suggested that RATS may present potential advantages over VATS regarding drained fluid quantity (MD − 29.83; 95% CI: −50.42 to − 9.23; P = 0.005), duration of hospital stay (MD − 0.14; 95% CI: −0.20 to − 0.07; P = 0.0001), lymph node dissection extent (MD 0.42; 95% CI: 0.18 to 0.66; P = 0.0005), and lower conversion to thoracotomy rates, which was achieved by the RATS approach (OR 0.18; 95% CI: 0.05 to 0.69; P = 0.01). However, the results failed to show any difference between the two systems regarding operation time, chest drainage duration, intraoperative bleeding, rates of complications, or air leakage rates. This meta-analysis and systematic review based on propensity score matching further enriches the existing evidence on RATS versus VATS for NSCLC. The findings show that RATS may hold certain advantages in some perioperative outcomes and surgical safety indicators. However, due to the high heterogeneity observed in some outcomes, clinical decision-making should involve a comprehensive evaluation based on the actual resource allocation of the hospital, the surgeon’s proficiency, cost-effectiveness, and individual patient factors, rather than relying solely on presumed technical superiority. Confirmation of this data is required by well-designed prospective, multicenter, randomized studies involving a greater number of patients, as well as longer-term follow-up.