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Postoperative pain after lobectomy: robot-assisted, video-assisted and open thoracic surgery

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Abstract

Surgical resection is the optimal procedure for early stage non-small cell lung cancer (NSCLC). Open thoracotomy, video-assisted thoracic surgery (VATS) and robot-assisted thoracic surgery (RATS) are different surgical modalities with possible different outcomes. The aim of this study was to analyze differences in outcome with a focus on postoperative pain. Patients undergoing lobectomy at the Maasstad Hospital in 2015 and 2016 were included. Postoperative pain was scored according to the Numerical Rating Scale (NRS). Additionally, duration of chest tube drainage and thoracic epidural analgesia (TEA), hospital length of stay and type of surgery were assessed. Lobectomy was performed in 57 patients. There was no significant difference in type of surgery, age, gender, right-sided surgery, postoperative NRS scores, duration of chest tube drainage and epidural anesthesia, and hospital length of stay (p > 0.05). Operative time for RATS was significantly longer (p = 0.002). Postoperative pain scores and other outcomes did not differ between the three different modalities in surgery for NSCLC. In the future, more minimally invasive surgery will be used in pulmonary surgery with thoracotomy as a safe alternative in selected cases. Future studies have to demonstrate if RATS will overcome the differences concerning cost-effectiveness over VATS.

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Authors and Affiliations

  1. Maasstad Hospital, Maasstadweg 21, 3079 DZ, Rotterdam, The Netherlands

    Augustinus P. T. van der Ploeg, George P. Akkersdijk, Charles C. van Rossem & Peter D. de Rooij

  2. Erasmus Medical Center, Rotterdam, The Netherlands

    Ninos Ayez

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  1. Augustinus P. T. van der Ploeg
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  2. Ninos Ayez
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  3. George P. Akkersdijk
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  4. Charles C. van Rossem
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  5. Peter D. de Rooij
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Correspondence to Augustinus P. T. van der Ploeg.

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The authors Dr. van der Ploeg, Dr. Ayez, Drs. Akkersdijk, Dr. van Rossem and Drs. de Rooij declare that they have no conflict of interest.

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All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000.

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van der Ploeg, A.P.T., Ayez, N., Akkersdijk, G.P. et al. Postoperative pain after lobectomy: robot-assisted, video-assisted and open thoracic surgery. J Robotic Surg 14, 131–136 (2020). https://doi.org/10.1007/s11701-019-00953-y

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  • DOI: https://doi.org/10.1007/s11701-019-00953-y

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