Single-Port Robotic Pulmonary Resection for Non-Small-Cell Lung Cancer After Neoadjuvant Chemoimmunotherapy.

OBJECTIVES

To evaluate the feasibility of single-port (SP) robotic pulmonary resection after neoadjuvant chemoimmunotherapy for non-small-cell lung cancer (NSCLC).

METHODS

We retrospectively reviewed data from patients who underwent SP robotic or SP video-assisted thoracic surgery (VATS) pulmonary resection after neoadjuvant chemoimmunotherapy at Korea University Guro Hospital between March 2018 and November 2025 and compared baseline characteristics, intraoperative and perioperative outcomes, and postoperative complications between the 2 groups.

RESULTS

Twenty-four patients were included: 10 in the SP robotic group and 14 in the SP VATS group. Baseline characteristics were comparable, except for histologic type (P = .033) and immunotherapy type (P = .011). One pneumonectomy was performed in the SP VATS group (7%). R0 resection rates were 90% in the SP robotic group and 93% in the SP VATS group (P = 1.000). The conversion rate to thoracotomy was 10% in the SP robotic group and 29% in the SP video-assisted group (P = .358). Other perioperative outcomes, including operative time, lymph node yield, drainage volume, hospital stay length, postoperative complications, and postoperative pain, were comparable between groups. One patient in the SP video-assisted group died of myocardial infarction.

CONCLUSIONS

Single-port robotic pulmonary resection after neoadjuvant chemoimmunotherapy is technically feasible and can be performed safely with acceptable perioperative results. Our findings suggest that SP approaches, including robotic and VATS techniques, can serve as viable minimally invasive surgical alternatives for appropriately selected patients with NSCLC.