Abstract
BACKGROUND: Robotic-assisted thoracic surgery (RATS) and video-assisted thoracic surgery (VATS) have been utilized in the context of complex pulmonary segmentectomy. However, the extant literature offers a paucity of information with regard to the early outcomes and inflammatory impacts of these approaches inadequately. We analyzed perioperative outcomes, inflammatory markers, and complications in 31 RATS and 66 VATS cases. METHODS: A retrospective study was conducted on 97 patients undergoing complex pulmonary segmentectomy for pulmonary nodules at The Affiliated Hospital of Guangdong Medical University between July 2022 and October 2024. Short-term surgical outcomes and inflammatory markers were compared. RESULTS: Among 97 patients with comparable baseline characteristics, no significant differences were observed in intraoperative blood loss, extubation time, or overall complication rates between RATS (n=31) and VATS (n=66). However, RATS demonstrated shorter operative time (174.00±50.67 vs. 224.24±61.65 min, P<0.001), reduced inflammatory responses [postoperative white blood cell counts: (9.90±2.10)×10(9)/L vs. (13.31±4.03)×10(9)/L, P<0.001], and fewer dissected lymph nodes (7.60±4.79 vs. 12.48±7.80, P=0.002). RATS also exhibited superior ergonomic design and three-dimensional (3D) visualization. CONCLUSIONS: For patients diagnosed with early-stage pulmonary nodules, RATS significantly shortens operative time, mitigates inflammatory responses, and enhances ergonomic efficiency compared to VATS.