Robot-Assisted Thoracic Surgery Versus Video-Assisted Thoracic Surgery for Lung Resection: A Systematic Review and Meta-Analysis.

BACKGROUND

Lung resection is a standard treatment for lung cancer. Video-assisted thoracoscopic surgery (VATS) is widely used as a minimally invasive approach. Recent advancements in robotic technology enhances the safety and efficacy of robot-assisted thoracic surgery (RATS). This systematic review and meta-analysis compared the clinical outcomes of RATS and VATS in lung resection.

METHODS

PubMed, ClinicalTrials.gov, and the Cochrane Library were searched from inception to June 2025. Primary outcomes were lymph node yield and operative time. Secondary outcomes included R0 resection, postoperative complications, and recurrence. Data were analysed using Review Manager v5.4.1 with random-effects models.

RESULTS

Twenty-nine studies involving 66,406 patients were included. RATS significantly improved lymph node yield (MD 4.54; 95% CI 2.91-6.17) and showed shorter operative time (MD -6.09; 95% CI -13.20-1.03). RATS was associated with higher R0 resection rates, fewer complications, and lower recurrence.

CONCLUSION

The findings support the safety and oncologic effectiveness of RATS.