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Vol. 100. Issue 8.
Pages 504-510 (August 2022)
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Vol. 100. Issue 8.
Pages 504-510 (August 2022)
Original article
Similar outcomes after newly implemented rats approach compared to standard vats for anatomical lung resection. A propensity-score matched analysis
Resultados similares de un abordaje robótico (RATS) recientemente implementado comparado con un abordaje VATS convencional para resecciones pulmonares anatómicas: análisis de datos emparejados por puntuación de propensión
María Teresa Gómez-Hernándeza,
Corresponding author

Corresponding author.
, Marta G Fuentesa, Nuria M Novoaa, Israel Rodrígueza, Gonzalo Varelab, Marcelo F Jiméneza,b
a Service of Thoracic Surgery, Salamanca University Hospital, Salamanca, Spain
b Salamanca Institute of Biomedical Research, Spain
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Outcomes after the introduction of surgical innovations can be impaired by learning periods. The aim of this study is to compare the short-term outcomes of a recently implemented RATS approach to a standard VATS program for anatomical lung resections.


Retrospective review of consecutive patients undergoing pulmonary anatomical resection through a minimally invasive approach since RATS approach was applied in our department (June 01, 2018, to November 30, 2019). Propensity score matching was performed according to patients’ age, gender, ppoFEV1, cardiac comorbidity, type of malignancy, and type of resection. Outcome evaluation includes: overall morbidity, significant complications (cardiac arrhythmia, pneumonia, prolonged air leak, and reoperation), 30-day mortality, and length of hospital stay. Data were compared by two-sided chi-square or Fisher's exact test for categorical and Mann–Whitney U test for continuous variables.


A total of 273 patients (206 VATS, 67 RATS) were included in the study. After propensity score matching, data of 132 patients were analyzed. The thirty-days mortality was nil. Overall morbidity (RATS: 22.4%, VATS: 29.2%; p=0.369), major complications (RATS: 9% vs VATS: 9.2%; p=0.956) and the rates of specific major complications (cardiac arrhythmia RATS: 4.5%, VATS: 4.6%, p=1; pneumonia RATS:0%, VATS:4.6%, p=0.117; prolonged air leak RATS: 7.5%; VATS: 4.6%, p=0.718) and reoperation (RATS: 3%, VATS: 1.5%, p=1) were comparable between both groups. The median length of stay was 3 days in both groups (p=0.101).


A RATS program for anatomical lung resection can be implemented safely by experienced VATS surgeons without increasing morbidity rates.

Lung resection
VATS lobectomy
Robotic lobectomy
Postoperative complication

La introducción de innovaciones quirúrgicas se asocia con períodos de aprendizaje que pueden afectar a los resultados. El objetivo de este estudio es comparar los resultados postoperatorios de un abordaje RATS para resecciones pulmonares anatómicas implementado recientemente frente a los de un abordaje VATS convencional.


Revisión retrospectiva de los pacientes sometidos a resección pulmonar anatómica mediante un abordaje mínimamente invasivo en nuestro centro desde el inicio del programa de cirugía RATS (junio de 2018) hasta noviembre de 2019. Los pacientes fueron emparejados por puntuación de propensión según variables de riesgo. Los resultados analizados fueron: morbilidad global, complicaciones (mayores, arritmia, neumonía, fuga aérea prolongada y reintervención), mortalidad a los 30 días y estancia hospitalaria. Los datos se compararon mediante la prueba de chi-cuadrado o la exacta de Fisher para variables categóricas y la prueba de U de Mann-Whitney para variables continuas.


Se incluyeron en el estudio 273 pacientes (206 VATS, 67 RATS). Tras el emparejamiento, se analizaron los datos de 132 pacientes. La mortalidad a los 30 días fue nula. La morbilidad global (RATS: 22,4%, VATS: 29,2%; p=0,369), complicaciones mayores (RATS: 9%, VATS: 9,2%; p=0,956), arritmia (RATS: 4,5%, VATS: 4,6%, p=1); neumonía (RATS: 0%, VATS: 4,6%, p=0,117); fuga aérea prolongada (RATS: 7,5%; VATS: 4,6%, p=0,718) y reintervención (RATS: 3%, VATS: 1,5%, p=1) fueron comparables entre ambos grupos. La mediana de la estancia hospitalaria fue de 3 días en ambos grupos (p=0,101).


Un programa RATS para resecciones pulmonares anatómicas puede implementarse de manera segura por cirujanos experimentados en VATS sin aumentar los índices de morbilidad.

Palabras clave:
Resección pulmonar
Lobectomía VATS
Lobectomía robótica
Complicaciones postoperatorias


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