Abstract
BACKGROUND: Lymph node dissection is essential for lung cancer staging and treatment planning. This study compares the extent and quality of lymph node dissection between robot-assisted thoracic surgery (RATS) and video-assisted thoracic surgery (VATS). METHODS: In this prospective cohort study, 40 patients undergoing oncologic lobectomy via RATS (n = 20) or VATS (n = 20) were included. We assessed the number of explored lymph node stations, dissected nodes, and microscopic integrity criteria. RESULTS: RATS resulted in a higher median number of explored stations (5 vs. 4; p = 0.0375) and resected nodes (8 vs. 6; p = 0.0432). However, no significant differences were found in the microscopic quality criteria. CONCLUSIONS: RATS enables broader lymph node dissection but does not improve microscopic quality compared with VATS. These findings highlight the need for further studies to assess clinical outcomes.